Allergic
Reactions After Drug Eluting Stent (DES) Hypersensitivity
Post to this topic if you are concerned
that you may be experiencing an allergic reaction (hypersensitivity)
after a drug-eluting stent (DES) procedure. Postings are listed newest to
oldest. Earlier postings are listed in the 2006
archive and the 2005
and earlier archive. Also
check the "related topics" that are listed in the right
hand column under the "DONATE" button.
Current Postings (159) -- Archived Postings
on this topic (234):
Hmmmm...weight loss,rashes metallic taste sounds
like what have going on-- short story long, Xience drug eluting stent
placed into circumflex last Oct '08 90% blockage thank you doc. End
up in ER
a month later with hypotension am told I have anemia, so they adjust
the Bp meds (lopressor, lisinopril) problems all winter also on Plavix
and aspirin the usual post stent drill from what I understand around
mid Feb am dizzy all the time itching rash gets worse end up in ER
again, cardiologist figures it's the Plavix sends me to allergy doc who
thinks
it's the Lisinopril. 4
months later still feel lousy and am med sensitive to stuff I have
taken for years rashes on neck, tongue burning and swelling feel like
crap.ANA
comes back positive along with dna Lupus? rheumatologist repeats blood
work says no! I'm beginning to think it's the stent any input would
be greatly appreciated. J.S., Detroit, Michigan, USA, May 21, 2009
Carol -- these are hard questions to answer
-- but you might want to contact the cardiology group in Texas (see
stentstudy in right hand column) with your story. Forum Editor, Angioplasty.Org, May 21, 2009
My husband had a Boston Scientific Liberte stent put in last September
2008. He was already on coumadin and then put on Plavix, and aspirin after the
stent. One week later he was admitted to the hospital for an internal bleed and
a blood count of 8. They found two bleeds in his stomach and ended up having
two endoscopies. Once he came home he started losing weight, no one had an answer
as to why he lost about 38 lbs. He has been through endoscopies, colonoscopy,
scans with and without dyes and chest x-rays. Has seen an oncologist and has
had numerous blood tests, all negative. We have exhausted all possibilities and
finally started thinking that all this started with the installation of the stent.
I did a web search and found this website. It would seem that we are not the
only ones that have experienced weight loss or side effects. The only other side
effect that we could pin to the installation of this stent was nausea but he
never had the metallic taste. Please let us know if there is anyone else with
this problem. And if so have you started regaining any of the weight back? Carol S., Winthrop, Maine, May 21, 2009
Note to Peter V -- I also experienced an allergic
reaction to Plavix and resolved it with a one day desensitization program
at the Scripps Clinic in San Diego, California No problems in the two
years since then. This might be an option for you so you might want
to contact the Clinic and see if there is a facility near you that could
administer this program. Good luck. Roger L., Los Angeles, California, USA,
May
1,
2009
hi I'm back. I just wanted to tell you that
I still have my rash it comes and goes and hard not to scratch .
The only time I can if my wife is not looking
hehehe I will be 71 in june and I just wanted to tell you. I walk on the
tread mill every morning for half hour speed 3.4 on mark up I'll want
to be ready
when I see my doc here and he says stress test its there favorite thing to
do. Maybe if they would do that themselves sometime they would have
more of a idea
what it is like heheh. Anyway its been since February since I had my three
stents put in and all I can say is give your self a little time .I
just cut my lawn
fist the front and I used a push mower can remember as far back as ten years
that I used to get a pain and would have to stop for a while .This time I
felt nothing I was walking cutting with a big smile on my face. I came
in and drove
my wife to work and thought why not do the back also and I have a big back
yard i usually use my tractor for it but i was so delighted I couldn't
stop and cut
the whole thing my yard is 100x 200 I did it and in proud of it i feel like
a 20 year old again.So if you feel a little discomfort at first its normal
. I just wanted to share this with you all. I say thank God the Doc
in Florida did
a angiogram and found my blockage 3 x 75%. I feel great and you will to see
you till next time, don't look at my typo's I'm not a good typer hehehe but
I
can
cut grass hehehe. Peter V., Ontario Canada, April 25, 2009
I'm extreemly happy with the quick response
I got about the cypher stents I'm on. As my rash is getting worse and
you explained to me several options.The problem here is when you read
all the problems there are with the stents, it's all doom and gloom
including myself. I thought ok is the the end of the road for me. But
when you
think of it only the people that are having a problem are writing.
And all the success stories you wont hear. I am going to write in here
even
after I get everything in order as it can help a lot of people. They
need to hear the good things as much if not more then the bad. I'm
70 years
young just celebrated our 50th wedding anniversary have 5 wonderful
kids and more grandkids then I can count including great grandkids So
let's
look at the positive side as well. I know if I didn't have the stents
installed I was a walking heart attack. I do think that the doctors
should talk to their patients and explain what each stent does for them.
Me
I was totally dumbfounded I didn't know one stent from the other. Had
I had the time beforehand to research that I for sure would have but,
things don't always work that way. I had no idea I had three arteries
blocked. Anyway my bp is normal and my heart rate is good just that
darn rash. and I hope all will work out for all of you. Feel free to
post
here to discuss our problems we face see you later and God
Bless. Peter V., retired??? mmmmmm not really so far i don't have the RE
part
and I'm just Tired:), Whiby, Ontario Canada, April 12, 2009
Peter -- patients with drug-eluting stents,
like the CYPHER, are recommended to take a minimum of 6 months of dual
anti-platelet therapy: aspirin plus clopidogrel (Plavix) or Ticlid (ticlopidine).
Many cardiologists extend this to 12 months or longer, to lower the risk
of late stent thrombosis, or blood-clotting inside the stent while the
artery wall "heals" over the stent itself. Check out our related
topic on Plavix
and aspirin: dosage and allergic reactions for some stories
from other patients, a number of whom report rashes as well. An allergic
reaction may be the results of a number of things, one that you mentioned
-- the contrast dye -- is not uncommon, and can be a delayed reaction.
Others are to medications, several of which are often initiated after
a diagnosis
of coronary artery disease. The incidence of allergies to the stents
themselves are very rare, although if other causes are ruled out, this
may be the case. A larger number of patients report a hypersensitive
(allergic) reaction to Plavix, specifically
causing
a rash. The challenge is to pin down the cause. If it is thought that
Plavix is the issue, there have been a number of studies done on how
to desensitize a patient to the drug. One recent study suggests
a short
course
of
antihistamines
and
steroids may
solve this. It was presented at the American Heart Association meeting
in October
and is titled Successful
Treatment of Clopidogrel Hypersensitivity Without Drug Interruption.
Most importantly, do not stop taking either aspirin or clopidogrel without
consulting your cardiologist and work with him/her to solve this problem.
We're glad, however, that outside of the rash, you feel great! Forum Editor, Angioplasty.Org, April 12, 2009
I am a healthy 70 year old and I live in canada. I was on vacation in
Florida in February and went to the hospital with a pain in my chest, after a
angiogram they found 3 blocked arteries 75% so they installed 3 Stents the name
of them is Cypher Sirolimus eluting. I feel great but I have this rash all over
my body. mostly on the chest area. First I though that it was the dye they used/I
had two stress test in canada , before I left and they showed normal. then the
angiogram also with dye and putting in the stents dye again. and a week after
that they did a nuclear stress test also with dye. So they put me on plavix and
a 81 mg aspirin along with the sotanol I was on with the 4 mg warfarin and a
pravastatin. The sotanol is just a prevention of AF I get now and then. also
the warfarin.what I like to know is will this rash get better as time goes on?
I'm at a total loss here. My Cardio doctor in Canada don't seem to sympathetic
and just told me to drop the aspirin to see if that will help. Any advise would
be really appreciated thank you. Peter V., retired not really so far i don't have the RE part and I'm just
Tired:), Whitby, Ontario, Canada, April 11, 2009
My father aged 67 received Angioplasty treatment
with 1 drug eluting stent and 1 simple stent on 1st March 2009. He
had suffered severe pain in hand for about 10 days, which has subsided
now.
From 10th March he is having constant hiccups The Doctor prescribed
Liofen (Baclofen), which gives him temporary relief. He also takes Dygene
to
eliminate Acidity if any. Still the problem is not solved permanently.
What could be the probable reason and solution? Rupesh S., Gujarat, India, March 21, 2009
Steve et al -- see the notice in the right column
about a research project being done regarding allergic reactions to drug-eluting
stents. The research team believes the reaction is to the polymer coating
on the stents, namely the first generation DES. They have some pretty
significant data to suggest an inflammatory response, which may account
for some of the reactions reported in this topic. Other reactions are
often due to the various medications that are prescribed for heart patients,
medications that are often only started once a diagnosis of coronary
artery disease has been made -- as such they are not related to the stent
at all. A third possibility exists, and we've started a separate
topic on this -- metal allergy. Virtually all stents, bare metal
and drug-eluting, are made with alloys that contain nickel. A percentage
of patients, more
predominately women, have nickel allergies (you'd probably know that
from jewelry, etc.). Whether or not a nickel allergy can cause adverse
reactions from stents has not been proven, but the FDA requires language
in all stent packaging to warn against implanting these devices in patients
with known hypersensitivities to any of the components, specifically
nickel or stainless steel. We encourage patients to read and post
to this new topic, especially if
you have a
known metal
allergy. Forum Editor, Angioplasty.Org, March 21, 2009
Two years ago I had DES placed in my heart.
I have had itching on my forearms ever since that have gone from mild
to wild. Prednisone seems to help but only
if dosed greater than 40mg per day. I have tried every cream, ointment, salve
available to no avail. I have seen a dermatologist who biopsied several areas
and said they showed some deep cell irritation like a reaction to medicine.
I stopped taking all my medications and the itching continued. I have
seen an allergist
who started testing but stopped when I had a reaction to one of the elements
of the test and a recurrence of the itching. He prescribed 10mg to 20mg of
Prednisone to help control the reaction. Like I stated earlier, I only
get relief from larger
dosing. I am open to any and all suggestions. Please help. Steve C., San Diego, California, USA, March 18, 2009
I had a taxus stent
implanted 3 years ago. for almost 2 years I have been suffering from
hives, swelling, burning
sensation on my skin diagnosed as Chronic Idiopathic Urticaria. I am
being treated with allergy meds and steroids and creams. the hives
come and go and move all over the body. I believe I am having an allergic
reaction to the coated stent. I have been to two allergists, a dermatologist
and my cardiologist. all do not know the cause. my question is has
anyone
suffered from skin hives, (urticaria) as a result of a drug coated
stent that was implanted?? what is the best recommendation to prevent
flare
ups that has worked for others? any info would be greatly appreciated!
thanks. Sadie, Miami Beach, Florida, USA, March 14, 2009
I had two des implanted in May 05, and
was only asked about sensitivity/allergy to drugs, but I have hayfever,
and a nickel allergy. 1 week after implantation
I had severe chest pain and had continued angina pain. I have never been
completely pain-free. Please note, I have been taking Plavix for probably
2 1/2 years out of the almost 4 yrs since implant. In Sept 07,I had worse
Angina pain ever, but was on holiday in Egypt at time and so chewed 300
mg aspirin, took gtn spray several times and also painkillers, until
pain subsided. Following day came out in hives, all over body, neck,
arms, legs. Bought over counter antihistamine tabs and cream and eventually
rash subsided after 5-6 days (whilst continually taking antihistamines).
As soon as I stopped taking them itching started. Back from holiday,
I saw my local doctor who sent of blood samples, which were ok, but itching
continued. Had referral to dermatologist, who prescribed Zirtec 10 mg
(April 08), and have been taking these daily since then. No allergy testing
was done, and I did not make the connection between the worsening angina
and rash/itching at that time. Also in November 07 whilst standing in
kitchen had syncopal episode. No warning whatsoever. I have never had
one before. During 2008, my angina worsened and exercise tolerance continued
to decrease. In October 08, my Cardiologist stopped the Plavix and changed
Amlodipine 10 mg to Felodipine 2.5 mg(because of terrible feet/leg swelling).
Since November 08, my breathing has become increasingly laboured, severe
exacerbations of breathlessness, later found to be caused by Felodipine,
which has now been stopped. Initially there was some improvement to dyspnea,but
this has deteriorated, and continues to do so limiting all aspects of
life to extreme. In January 08 I had a selective angiogram which showed
minor in-stent restenosis of 20-30%, ostial stenosis of around 90% in
the first small septal branch, and a 20% plaque in the mid LAD beyond
the stent implant, (which had not been there at time of angioplasty}.
No further angiogram since.
MY QUESTIONS ARE:
WOULD ANY INFLAMMATION SHOW UP IN AN ANGIOGRAM?
WOULD THE ZIRTEC ALTER BLOOD TESTS, WITH REGARD TO C REACTIVE PROTEIN,
PARTICULARLY AS I AM ON A STEROID INHALER AND HAVE HAD TWO COURSES
OF STEROIDS, PRIOR TO THE BLOODS TAKEN.?
WHAT MIGHT HAPPEN IF I STOPPED TAKING THE ZIRTEC? (I DID MISS A DAY
ON TWO OCCASIONS, AND HAD TERRIBLE ITCHING AND RED SPOTS AND WEALS.)
COULD I BE HYPERSENSITIVE TO THE STENTS?
I am waiting to see Dermatologist/Allergist and wonder how long the Zirtec
remains in a person's system. Thanks for any info/opinion you can provide. Barbara, Great Britain, February 9, 2009
Beginning Jan '05 I have had 4 interventions each one requiring 2 stents
for a total of 8. I am 62 and just had my last procedure. The first went fine,
then in Aug '05 I had 2 more stents and for months I felt like hell. Weak, extreme
fatigue. The 3rd went fine March '08 I was OK then Jan '09 the 4th. Again extreme
fatigue. I'm ok if sitting but moving around I just want to lie down. I cannot
do 1/3 of what I could before this last. I have always been sensitive to any
statin or ace. They put me on lisinopril I quit a week ago to see. No change.
I have been on plavix, metoprolol, aspirin for years. I am finally leaning towards
getting
a by-pass. I can't stand this fatigue. Tom L., South Carolina, USA, January 18, 2009
My husband has been on Plavix since January
of 2008 after stent surgery. He has been suffering with a painful and
itchy rash and his skin is all blotched. We have exhausted our general
physician, heart specialist and dermatologist. We are going to another
dermatologist in Boston hoping to get to the bottom of his rash. We
feel now it is either the Plavix or the medicated stent (Taxus Express
2 Paclitaxel-Eluting
Coronary Stent System.) D., Londonderry, New Hampshire, USA, October 20, 2008
Jeannie -- the amount of drug that is given
off (eluted) by these stents is pretty small, and pretty localized
-- much less than the dose level you'd get when taking Taxol as an
anti-cancer drug, for example. Which is not to say you're NOT having
a reaction.
But this is hard to pin down. Perhaps other meds? Many heart patients
are prescribed new meds when they are
diagnosed
with
CAD
--
perhaps one
of
your blood
pressure drugs needs adjustment? Forum Editor, Angioplasty.Org, May 21, 2008
I had a DES inserted into RCA April 4, 2008.
I had a 70% blockage in that one artery. All others are 20-30%. I am
a 61 y/o white female, retired RN. After the Cath, I came home the next
day. Dr. told me to "go back to normal activities" the following day.
I did. I normally walk every morning for 30 minutes before breakfast.
I was very short of breath! felt terrible, Checked my b/p when I got
home, it was 96/48. I rested. Same occurrence the next day. I called
the cardio, he told me nothing he did could have caused decreased b/p.
He was a little concerned about the SOB. I looked up the DES. Taxus 11
eluded [eluted] with Taxol and the side effects of Taxol. These included
SOB, Hypotension. I asked cardio he said no...the eluding [eluting] process
was minimal drug exposure. The SOB is minimal with exertion, hypotension
continues in afternoons. I have since had EKG, Echo, Lab work to rule
out clot. All
OK. Possible allergic reaction to stent?? Jeannie Jeter, Summerfield, Florida, USA, May 20, 2008
J.J. from UK -- here are some references to
warnings about implanting stents in patients with metal allergies. The
FDA warning is for all metal stents (bare and drug-eluting), not just
the examples quoted here. The same language is in both the Instructions
For Use (IFU) for the CYPHER drug-eluting stent (page 4) and from
the Directions
for Use (DFU) for the TAXUS drug-eluting stent (page 2): "Patients
with a known hypersensitivity to 316L stainless steel may suffer an allergic
reaction to this implant." and so on. The part of the stainless
steel alloy that seems to cause the allergy is nickel. (Also, many metal
surgical devices are made with Nitinol, a nickel-titanium alloy). The
tricky part here is the phrase "with a known hypersensitivity." How
such a condition becomes "known" is dependent on the patient
communicating this knowledge to the physician. Patients are supposed
to be questioned about allergies before a stent (or pretty much any medical
procedure) but this query ("are you allergic to metal?") often
gets lost in a long list of questions. Moreover, many patients may not
be aware of their condition. Does this mean every potential stent patient
should be given an allergy skin patch test? Forum Editor, Angioplasty.Org, May 20, 2008
Dear Forum --
Thank you for your support so far. I am still trying to find out the make of
stent that my mother had fitted and also to convince the specialists that
there is the possibility of metal allergies and stents.
In your post of 5th May 2008 you referred to the FDA-mandated package inserts
for All stents that urges caution against implanting stents in patients
with known allergies to nickel and chrome. Could you please give me a reference
for this info – i.e. a document on the web that I can research further
and pass on to the specialists? My google searches so far have not been
able
to locate anything (this could be due to me struggling because of my
medical ignorance!). Your support and advice is much appreciated. Many
many thanks. J.J., United Kingdom, May 19, 2008
Thank you so much for your reply to my enquiry.
Just this initial info that you have provided has given me the conviction to
pursue the matter further (my Mother had again to visit the emergency
Department of the hospital this week after suffering another trembling
attack – the Doctor examined her for neurological causes ie a series
of reflex tests which proved negative and they are investigating thyroid
blood tests). I have contacted my Mother’s heart specialist and asked
for details of the stent that has been fitted and have included details
of your response which hopefully will provide some justification for
exploring the possibility of an allergy. I will advise you of any response
I receive.
In the meantime I would once again wish to express my gratitude J.J., United Kingdom, May 9, 2008
The stent
allergy study we are helping with
concerns reactions to drug-eluting stents, most likely to the polymer
plastic coating. From the description and history you sent in, it sounds
like your mother has a known allergy to chrome, or other metals.
Chrome dental clasps are actually an alloy of nickel and chrome. Nickel allergies
have been well-documented. Most stents are made of surgical stainless
steel which contains nickel. The FDA-mandated package inserts for ALL
stents, bare metal and drug-eluting, caution against implanting stents
in patients with known allergies to these metals.
Sounds like the doctors are saying the stent was "plastic-coated". That would
indicate a drug-eluting stent. Do you know the name or brand of the stent? Forum Editor, Angioplasty.Org, May 5, 2008
My mother, aged 75, has a history of angina
and had a stent fitted on 9th June 2007, at Sandwell District Hospital.
Since then she has spasmodically not been feeling well – her symptoms include
sickness, headaches, trembling. The most recent of these “turns” has been today – she
went to the hospital and had a full check on her heart including an ECG, blood
pressure etc. The doctors assured her that her heart was fine. I have today started
to research the possibility of an allergic reaction to the stent – we have on
numerous occasions raised this with the Doctors but they have dismissed our theory.
They say it is nerves, or rheumatism or age etc. The reason why we think it could
be an allergic reaction is that my Mother’s symptoms are very similar to what
she suffered some 15-20 years ago – it transpired that she had a reaction to
a denture clasp fitting which turned out to be chrome – when this was eventually
removed she recovered rapidly. Until that point she had suffered a general feeling
of being unwell and unable to participate in activities etc. The doctors have
said that the stent they have fitted is not metal but plastic coated – to what
extent they are certain of this I do not know – but given that my Mother is susceptible
to allergic reactions and I have discovered that some people do suffer even when
it is plastic coated I feel it is worth pursuing this line of enquiry. Especially
given the impact of the general feeling of constantly being ill is having on
my Mother’s general well being and making her so depressed given that normally
she is an exceeding young and active 75 year old. I would very much welcome any
information/advice that you can provide. Many thanks. J.J., United Kingdom, May 2, 2007
Deborah and Niloofar -- as we've noted before,
very little is known about hypersensitivity reactions to drug-eluting
stents -- and one of the confounding issues is that patients with stents
are also patients who take a number of different medications, each of
which has its own set of adverse or allergic reactions. Also, because
these reactions are small in percentage, it is very difficult (and expensive)
to run large enough studies that will yield valid data. Two cardiology
groups in Texas and Chicago are studying this (see "To Patients" notice
in the right column). What they do is remove each medication (substituting
a
different one) to rule
out
drug
reactions,
and then do a skin patch test with small pieces of the various stents.
If
the
skin reaction is positive, there is a high likelihood of allergy to some
part of the stent (it is thought that the polymer-coating
is the culprit). One option is to visit an allergist to see if a drug
you are taking might be the cause. As for a fever and rash two years
after stent implantation, probably unlikely -- and certain antibiotics
are known to cause rashes in some people. Forum Editor, Angioplasty.Org, May 2, 2008
I have a problem that I haven't read here. I
had 2 medicated stents inserted in Feb of 05. 10-12 days later I had
several canker sores in my mouth. At the
time I was 53 Years old. Before then I may have had 2 or 3 in my entire life.
Ever since then I've repeatedly had 1 or up to 3 in my mouth. After it heals
I get another. I am seldom without them. Is this some kind of reaction to the
stent (or Plavix) or did I pick up something in hospital. Help!! Deborah, Alabama, USA, April 26, 2008
Greetings, My Dad is 82 years old and had two
DES put in his heart, two years ago. Few weeks ago he caught the flu
and a week after he was recovered, he had high fever for 24 hours and
was put back on antibiotics, which led to having rashes. Could the
rash and fever be a reaction due to the DES? I appreciate any feedback.
P.S.:
he is taking plavix, metoprolol, lipitor,
flomax, Nexium. Niloofar Yekani, Connecticut, USA, April 15, 2008
Debbie and Sue -- we have sent you information
about the stent hypersensitivity study being conducted in Texas and Chicago.
if you browse around this toipic, you'll see a range of unexplained symptoms
that patients
have
reported
to us,
symptoms that started after a stent was implanted. There are 4 possibilities:
reaction to a prescription drug
started at the same time as the stent;
reaction to the drug-eluting stent
itself (most likely
to the plastic
(polymer)
coating);
reaction the the metal in the
stent; and
reaction is unrelated to any of
these and is coincidental.
Many patients report that
their physicians believe this last explanation is the most likely,
But given the number of postings here and the similarity in symptoms,
we
disagree and think
that the last explanation is
the least likely. Drug and metal reactions can be tested for
by an allergist. If they don't exist then a possible explanation is
a reaction to the drug-eluting stent. The study being done by the Texas
and Chicago hospital does exactly this -- they eliminate other causes
step-by-step and then administer a skin patch test, using a small part
of an actual
stent. They report to us that they are definitely seeing a correlation
between positive patch tests, symptoms and inflammation at the stent
site. The reason most doctors are unaware of this possibility is that
there have been no studies published on the topic. The study we are
involved in is the ONLY one of its kind, to our knowledge. Forum Editor, Angioplasty.Org, April 11, 2008
My mom had a Cordis stent put in in January
08. Immediately after she started to complain of intense pain in shoulders & arms & wrists.
Her hands went numb & were so pained she would go days without sleep.
Shortly after that both her knees blew up & were very painful. She
is not able to get up from a sitting position. she is on Plavix. She
was diagnosed with carpel tunnel in both hands & had surgery on one
so far. The pain has subsided in that hand but not the tingling & numbness.
Her cardiologist insists this is not relayed to the stent or the plavix.
i am finding it harder & harder to believe. can you please furnish
me with as much information as you can on side effects of medicated
stents & plavix.
i forgot to mention she took Vytorin for a month after surgery as well.
My mom's health was great before this stent. I suspect she is rejecting
it. Any help would be appreciated. Thank you Sue, Florida, USA, April 5, 2008
My mother had two stents placed in her heart
in January 2008. She has had severe nausea EVERY DAY since then. She
had congestive heart failure but never had any stomach problems before.
The doctors have done many many tests and have given her every kind of
medication. She is now on the medication given to chemo patients for
nausea and she sleeps all the time or is very sluggish when awake. Her
quality of life is GONE. We were not told of any side effects at all
before the stents were put in. The doctors are very indifferent about
this problem and act as if it is a total mystery to them and they have
never heard of this reaction!! Please let us know what can be done!!!!!!!!!!! Debbie N., Indiana, State, USA, March 30, 2007
Brian -- hard to say, which is why we're sending
you information about the drug-eluting stent study being done in Texas.
One of the protocols is to take patients off of each drug (using an appropriate
substitute) and once that's been done and the symptoms remain, they use
a skin test to see if there might be a reaction to the drug-eluting stent
material (not so much the metal, but the polymer/drug combo). Read our
article "Drug-Eluting
Stents May
Cause Allergic Reactions" about a study published two years ago -- this
is still a little-understood syndrome and, as newer drug-eluting stents come
on the market, may change. Hope this helps. Forum Editor, Angioplasty.Org, February 3, 2008
I am a 45 year old male. On Dec 26, 2007
had one Taxus Express 2 drug-elating stent placed in the circumflex (which
was 80% they also
say I had a 100% that fixed itself). Upon discharge, I was placed on Plavix
75 mg., Metoprolol Succinate ER 25 mg., Lipitor 80 mg., Altace 2.5 mg.,
Ecotrin 325 mg.. all once a day. (prior to stent placement only meds I
was taking was Lipitor 20 mg and Ecotrin 81 mg Once a day) Had no hypertension
issues and cholesterol on Lipitor was about 140 (good cholesterol was a
little low)
I informed the Cardiologist I was against such a raise in the Lipitor
(from 20-80) he stated it was just for 2 weeks, well after 2 days I could
feel the pains in the lower back and the legs, I called him and immediately
put myself back down to 20mg. This was on 12/29/07.
Went back to work as Bus Operator on 1/10/08, everything was fine until
1/21/08, At the end of my shift, My arms, elbows, wrists, hands, fingers,
knees, and ankles were very painfully swollen and sore. I had to go the
the emergency room, they drew blood and told me it was probably an allergic
reaction from the Altace (ACE inhibitor). The E.R. gave me an I.V. with
Benadryl, Steroid and pain killer, went home 3 hrs later feeling fine.
Stopped taking everything except Plavix and Ecotrin on 1/22/08. Stayed
home until 1/25/08 went back to work and at the end of my shift, the same
thing happened with all the same muscles and joints swollen and painful.
Saw the Cardiologist on 1/28/07 he placed me back on the Metoprolol and
lowered the Ecotrin to 160 mg. While still badly swollen, I saw my PCP
on 1/30/08. He also agreed that this more than likely is a reaction from
the ACE inhibitor He placed me on Prednisone 20mg and Benadryl 25mg once
a day and return to Lipitor 20 mg. and lowered the Ecotrin to 81 mg.. This
seemed to clear everything up. So I went back to work on 1/31/08 with the
same results, at the end of my shift at night all the same muscles and
joints became swollen and painful. I went back to my PCP and he raised
the Prednisone to 60 mg. for 2 days than 40 mg for 2 days than 20 mg for
6 days. He also suggested that I change the Metoprolol to Coreg CR. I'm
going to take the next 7 days off to rest the muscles and joints than try
to go back to work.
I've been doing a lot of internet surfing in my free time at home, nobody
seems to be definitely positive that it is the ACE inhibitor, The E.R.
said it could take a couple of weeks for the ACE inhibitor to clear out,
is this true?.I'm afraid it might not be. Could it be the DES or one of
the other drugs (never had any problems with Lipitor) I been pretty healthy
and active all of my life, playing racquetball once a week, mowing the
lawn, swimming etc.. I'm new at this and quite concerned about what my
next step should be if this problem persists. Help!! Brian G., New York, USA, February 2, 2008
A. Gregory -- aches and joint pains are a known
side-effect of statins. You should discuss this with your cardiologist --
perhaps other methods of lowering cholesterol can be an adjunct.. Let us
know what he/she recommends. Forum Editor, Angioplasty.Org, February 2, 2008
I have been taking Plavix,
Hyazaar, Herbessor,Vasteral and Lipitor. I am a 58 year old female. I
get a lot of aches and pains
almost everyday but I need to get my Cholesterol down so I continue with
taking Lipitor. Lovastatin also does the same thing but it does not lower
the Cholesterol. In the long run is it
harmful if I carry on with the Lipitor? A.Gregory, Malaysia, January 29, 2008
R.G. -- we can't give any specific medical advice,
but you're definitely doing the right thing by meeting with your cardiologist
about your drug regimen. Sounds like the statins might have been causing
problems, but again -- this is something only your doctor should advise
you on -- not us, or any internet site! We've
definitely heard a lot from people with nickel allergies -- we've not found
any medical literature definitively stating that this can cause serious
reactions, but the cautions DO exist in the "Instructions for Use (IFU)" mandated
by the FDA, so there must be some evidence. Forum Editor, Angioplasty.Org, January 29, 2008
My list of medications include two statins atenolol,
cozaar, Lasix, another blood pressure medication and 2 medications for
acid reflux.
I have just recently stopped the statins. The docs adjusted the statins
down to an every other day administration. But I have felt so much better
on the days that are absent the statin that I have taken an occasional
extra day off of the med. This last weekend I decided not to take the statins
(Zetia and Pravachol) and am able to get out of bed and have noticed less
pain. I will be addressing this change with my physician. I was not asked
about anything but medication or food allergies. I remember because on
a later hospitalization I added nickel to my list. Statins are on the list.
What are options for my predicament? R.G., Wisconsin, USA, January 29, 2008
Valerie -- stents cannot be "removed" once
placed. But drug-sensitivity to Plavix is a known problem (rash, etc.).
Read over our Forum Topic on Plavix
and Stents.
There is information there that may sound familiar. As for dealing with
this situation, several groups have published papers on desensitizing allergic
reactions to Plavix -- one in Iowa and also at Scripps in La Jolla. We'll
soon be posting an exclusive interview with Dr. Karl von Tiehl of Scripps,
lead author on a paper published in the November 5 issue of the Journal
of the American College of Cardiology, titled "Clopidogrel
Desensitization After Drug-Eluting Stent Placement". In this paper,
which you might want to show to your cardiologist, Dr. von Tiehl describes
the protocol for desensitization which, he tells us, is one which any qualified
immunologist familiar with the area of drug desensitization should be
able to carry out. If you or your doctor have further questions, feel free
to post here, or even call Scripps. Good luck and let us know how you fare. Forum Editor, Angioplasty.Org, January 29, 2008
My dad (75, quadruple bypass 5 years ago) had
angioplasty 3 weeks ago and had one DES put in for a significant blockage
in 1 artery. He was put on Plavix but seemed to have an allergic reaction
(itchy rash on chest) and was then put on Ticlid He's now experiencing
a worse itchy rash. His cardiologist had said before there was no alternative
to taking one of these 2 drugs for at least 5 months, that Coumadin
and aspirin wouldn't work for this. How can we find out for sure if he's
allergic to these medicines, or something in the stent itself, or maybe
even the dye used in the angiogram? And if he is allergic to both medicines,
what can be done? Remove the stent and put in a bare metal one? Another
bypass? Valerie M., New York, USA, January 29, 2008
R.G. -- yes, pretty much all stents (drug-eluting
AND bare metal) contain nickel and the FDA package insert / instructions
for these clearly state that the device should not be used (or used with
caution) in patients with known hypersensitivity to any componet of the
stent.
The tricky part here is the "known hypersensitivity" (a.k.a. "allergy")
-- patients are supposed to be asked about allergies, etc. but we've
found that many patients report not having been queried about this --
or they don't realize how important this information can be. It's also
not clear as to how severe such a metal allergy can be (the stent is
quite small). Are you taking other meds? For example, joint pain is a
known side-effect of
statins.
But definitely see your cardiologist about your reactions -- he/she should
be able to offer you some information and help. Let us know what you
find out. Forum Editor, Angioplasty.Org, January 20, 2008
I wonder if I am allergic to Plavix? My symptoms
include stomach upset, shortness of breath, severe pain in ankles and
wrists. I am lactose intolerant and I have read that Plavix tablets
contain lactose. I am allergic to nickel and I have read that taxus stents
contain
nickel. I would like to know if this is true and how should I approach
the possibility of allergic reaction with my cardiologist or my family
physician. I have had 4 stents placed in my RCA and D1 and continue
to be semi bed ridden. What do you suggest? R. G., Wisconsin, USA, January 18, 2008
I am a 56 year old female that has recently
(Nov.2007) had a Taxus Drug Eluting stent put in my LAD artery that was
99.9% blocked. I also had an angioplasty
done on a smaller artery at the same time. I was involved in a car accident
on Aug.11th, 2007, no fault of my own, this accident caused a major back
problem
that I was scheduled to have surgery on Nov.29th 2007. I began having chest
pains, some worse than others, that concerned me enough to see my family
Dr. He did
an ekg, showed a problem, had a stress test which also showed a problem. My
Dr. sent me to see a cardiologist in Joplin Missouri.He did an echo-cardiogram
and
found the problems. He never told me that my condition was life threatening,
but he did tell my husband that the front part of my heart was barely getting
any blood or oxygen to it. Had my heart work done on Nov.26th, 2007. the first
thing I noticed immediately, was that my breathing was sooo much better!!!
I felt wonderful until 4-5 days after my procedure. Then, all hell broke
loose.
I developed a itchy red rash like I have never experienced before! I still
have scars where I scratched so hard. My Dr. gave my a 6 day series of
a steroid pill
which got rid of it. I guess I'll never know the cause of the rash, I thought
it might have been the white contrast dye that was used to find the blockages.
Since then, I have never felt better. My cardiologist was a gift sent from
God, as I was so close to having a heart attack. Ironic, how an auto
accident actually
saved my life. I think the stress of the wreck is what started these angina
pains, the pains are what made me get checked out. I feel like the Taxus
stent has given
me a 2nd chance at life. I feel great!!! Thank you, thank you, thank you to
Dr. Robert Stauffer, Freeman Heart Institute Joplin Missouri....... Norma Wilkes, Afton, Oklahoma, USA, January 14, 2008
My name is Ken and I posted on this site in
Oct/Nov of2006. In Aug 2006, I was given a cypher stent. I had 3 previous
bare metal stents with no problem. I had refused the cypher stent,
declined it in writing in 2004 when it was brand new, as I have a severe
allergy
to all Mycin drugs and their derivatives, This was clearly noted on
my charts and records at the hospital and with my Dr. also on my allergy
wrist band. 1 week after implant of stent I was readmitted with severe
pain and blood pressure at 240/127. Re-catheterization showed the stent
was still in place but during procedure I went into full arrest. Did
I mention that I also have a pacemaker from 2005. I survived and wished
that I had not. I lived with severe pain for several months and slowly
regained some signs of life as the drug wore off. Problem came back
in
august 2007, and my NEW TEAM of specialists, did not feel that the
stent was the problem. Back into cath lab and two more stents BMW were
placed
in to relieve recurring pain and weakness in left side. November I
began to fail badly. BP out of control with any medications, back into
hospital
emergency room late november. Diagnosis was restenosis 95% or more
in the medicated stent. Also showing some muscle damage to heart. Overworking?
Bottom line on Monday 1/14/08 I will be back in again for bypass surgery
to the blocked gx--ffd cypher stent. Never, Never Never risk a medicated
stent. Be aware that Drs make more money using them and there is no
way
that I will ever believe that my first Dr was acting in my best interest.
When I said no medicated stents I thought it meant forever. His lawyers
argue no. With my other problems, I will survive this ordeal ONLY BY
THE GRACE OF GOD... I TRUST IN HIM and No-one else. I did report this
to the texas team doing the study and heard nothing. I wonder who is
paying their bills. My bills for health last year $175,000.00 20% out
of pocket. Ken Feeley, Bonita Springs, Florida, USA, January 12, 2008
Jackie -- the red rash is often a sign of allergy
to a drug, usually Plavix -- but your aunt should NOT stop taking Plavix
-- it's critical after stenting to stay on antiplatelet therapy to
avoid clotting. One question: did your aunt begin any new drugs at the
same
time as the stent placement? These might be one cause, but she should
certainly
see
her
interventional cardiologist and discuss these symptoms with him/her. You
might also email us at the address in the sidebar (under the "DONATE"
button) to get some information on the stent allergy study being conducted
in Texas. Forum Editor, Angioplasty.Org, January 11, 2008
I have an Aunt in Arkansas and she had drug eluting stents (6 months ago).
She started the day she had them with vomiting, then she began to break out all
over her body with a red rash and itching. She has been to all kinds of doctors
and has continually gone down hill. She is very weak, has very low blood pressure.
She was doing well until the stents were placed in her. She now has begun to
have kidney and bowel problems. Do you know if she needs to go to an allergy
doctor to find out if she is allergic to the stents or the medication in the
stents? Jackie, Millington, Tennessee, USA, January 8, 2008
Plavix and Aspirin Resistance is another Issue.
If the Plavix fed bleeding Ulcer don't kill ya then your dual antiplatelet
the rapists oops (therapy) aint workin because as many a 1/3rd tested
on such may be resistant to Plavix and aspirin see Accumetrics VerifyNow
to
get tested, Then ask your doc why he didnt
test before. stent clots x 3 and counting , realist, Florida, USA, January 7, 2008
On Sept.19, 2007 I had two DES placed in my RCA
and D1. One is extra long. I was told that I had two 80% blockages. Afterwards
I experienced some slight
pressure in my chest and an ache in my right arm which have worsened as of
this date. I am short of breath while doing the most simple thing. I have
an allergy
to nickel but was not informed that DES have nickel in them. The cardiologist
thinks that I am just sensitive to the stents. But I am sick and very tired.
Walking on a treadmill for 20 minutes is my limit. I cannot motivate myself
to exercise. Any suggestions would be appreciated. Rachel G., Wisconsin USA, December 28, 2007
Does anyone have any ideas as to how to become
desensitized to the des stents themselves, 6 allergy pills are not quite
enough even while watching my
diet very carefully? Denise Pgh PA again Denise Knoche, unfortunate recipient of 2 des stents in RCA, Pittsburgh, Pennsylvania,
USA, December 26, 2007
I have a Boston Scientific Taxus stent and a regular
stent. I had the regular metal stent for 5-years. I've had the DES since
Feb 2006. I have experienced
a higher CPK-level 199 and SEDRATE 32 (associated with inflammation). I have
swollen features associated with inflammation. I have been put on a water pill
to reduce swelling and it hasn't helped. I was on Vytorin (statin) for awhile
longer than the DES. I have experienced muscle soreness and weakness. I used
to run 2 miles at 3.6 mph. No longer can I even walk without my left leg dragging
due to weakness after 10-mins. I am right-handed and my right-arm is so pained
that I cannot reach across my body to wash the left-side of my body. My muscles
are so weak and pained that I cannot sleep through the night w/o tossing and
turning due to my body touching a surface. NOTE: I bought new mattresses about
1-year ago because I thought my back pain and body soreness was due to my mattresses
- it was not. I went to a neurosurgeon for back surgery who indicated that
I was not hurting where I should have been hurting for the back misalignment
which
was analyzed in an MRI. So, he sent me to a Physical Therapist. On day one
with the PT, she indicated that my pain was muscle since she could not
move my legs
without my screaming in agony. I was taken off of Vytorin (statin). I am feeling
a little better but the inflammation and pain persists. My CPK and sedrate
is still high. My neurosurgeon has referred me to a neurologist. Cynthia, Indianapolis, Indiana, USA, December 13, 2007
Four weeks after having a coated stent installed
in 2005 I started to have severe joint pain in my hands and feet. I still
have this today and I have had MRI's to examine the joints and there
was no Arthritis. I had no history of joint pain before this time and I
would
like to know if anyone else has experienced
this problem. Ken A., Pennsylvania, USA, December 11, 2007
Sharon -- you wrote in about a "stainless steel/nickel
implant" -- are you talking about a stent? Or something else. We haven't
heard anything about fungus infections from stents. Does anyone out there
have any info on this? Forum Editor, Angioplasty.Org, November 29, 2007
I had a stainless steel/nickel implant and I
developed a fungus infection from it. Mold releases mycotoxins which
are a neurotoxins. It is a multi-symptom, multi-system disease. I am sick
as
a dog and am going through detox but getting better. Mold exposure is
a biotoxin disease. Why in the name of good medicine did it take me five
years to figure this out. Why did the doctors not look for a fungus infection.
Fungus infections have been around for millions of years why would the
medical profession not look for this? Sharon, Denver, Colorado, USA, November 28, 2007
Martha -- thanks for the quick response. It seems
that it would have been better if the nurse-practitioner had talked to
you PRIOR to your procedure. This is something that we at Angioplasty.Org
have been writing about and campaigning for since more than a year ago.
It's something we testified to the FDA about. Patient AND physicians need
more
education
about drug-eluting
stents and the need for long-term Plavix. Not just whether drug-eluting
stents are as safe as bare metal stents -- the important issue we see is
exactly what you've experienced. Physicians need to be aware of the implications
of implanting a device in someone -- a device that requires the patient
to
stay compliant with dual antiplatelet therapy (Plavix and aspirin) long-term,
for a year, two, maybe for life. And they need to communicate these implications
to patients BEFORE stent implantation. Some patients cannot be compliant
for financial reasons (see our topic on Financial
Assistance for Plavix for some unfortunately good examples); others
cannot be compliant because of allergies or clinical conditions such as
yours; others may need to have surgery in the near future, and Plavix often
needs to be stopped for that. All these issues need to be weighed against
the higher incidence of restenosis with bare-metal stents -- but it's a
decision that should include the patient! Forum Editor, Angioplasty.Org, November 24, 2007
You asked why the nurse practitioner said I should
have not had a medicated stent. She presented me with the facts about
taking Plavix and said I would not have had to take it as long, 3 months
only
with a bare metal stent. My history of reactions to meds. is several
medications with two hospitalizations. She changed me to Ticlid for a while
after this
pain and weakness in arms started but it didn't change anything so I
was told to go back on Plavix. I thought it was more heart problems but
went
in for an Echo and the Cardiologist said it was not my heart but a flare
of my arthritis. My Rheumatologist put me on 20 mg. Prednisone daily
and I usually respond quickly with that but so far none. It has been 3
mo.
since my stent placement. Martha M., Missouri, USA, November 24, 2007
Martha -- can you tell us precisely why the nurse-practitioner
said you shouldn't have gotten a DES? We know that Ticlid can cause liver
problems, so it's not recommended. Reduced liver function also brings up
a "use with caution" for Plavix, but it's not an absolute contraindication.
We're assuming the nurse is concerned that you'll need to be on Plavix
for a
year, whereas
with a bare metal stent, it would only be 6 weeks. What has the interventional
cardiologist said about this situation? He/she may have had a good reason
for the medicated, or drug-eluting stent (DES) but what is the explanation
for why you're not feeling
well? There is a study going on out of Texas which you can get more information
about in the right hand column. Forum Editor, Angioplasty.Org, November 24, 2007
I recently had a medicated stent (that was
all the Dr. told me) I am not sure which kind. I also have a liver disease
called Primary Sclerosing Cholangitis, caused by the type of arthritis
I have. After I had surgery the Nurse Practitioner
came in and said "you shouldn't have had a medicated stent" did you not tell
your Dr., I said "no but it was on my chart", she said don't ever depend on the
Dr. reading your chart. Two weeks after having my stent placed I started having
very severe arm & shoulder pain, called and made an appt. with the cardiologist,
he said nothing wrong with your heart and sent me to my Rheumatologist, she gave
me a Prednisone shot and 20 mg. Prednisone daily. My response has not been good,
usually when I have increased inflammation it will get better quickly with Prednisone.
I was changed to Ticlid from Plavix which did not do any good, now back on Plavix.
I am desperate for help, I feel so much worse than I did before the stent. I
truly feel that I am allergic to it. Had I known the facts and been asked which
stent I preferred I would have said "bare metal". However I am just a patient,
since I have lived with this body for 74 years I know there is something else
wrong. I can't comb my hair or put dishes in my cabinet because my arms and shoulders
are so weak and painful. Martha M., Missouri, USA, November 23, 2007
I am a 43 year old Australian woman who had
three cypher stents following
an arterial dissection in my LAD. Like Ken R from Georgia, I have had dull chest
pain and tingling in my left arm since my heart attack. It, too, lessens with
exercise and drives me crazy some days like a tooth ache. My doctors seem to
think it's psychological. If anyone can shed some light on this problem, I'd
appreciate it. I don't think it can be related to the stents as it was there
post heart attack and prior to any treatment at all. Michele Medway, Gunning, New South Wales, Australia, November 22, 2007
I'm a 36yr male Correctional Officer, Pos PPD,latent
TB 2004 Had a reaction to INH (chemotherapy medication)caused Neuropathy
in tongue(burnt taste),fingertips toes,sides of legs,tinnitus,extreme
fatigue,memory loss, gallbladder disease(gallbladder removed june2005),
B-12 Deficiency discovered right before gal bladder removed started b-12
shots in july...they helped a lot LAD stent(Taxus express2) put in on
11/14/07 I told the ER I was allergic to INH...I guess they couldn't
put
2&2 together..I felt fine for 1 day after surgery and have started feeling the
same pain that I was experiencing before surgery....I just found out that the
coating on these stents are (chemotherapy medicated) Hello! I am reading all
of these stories just looking forward to what Ill have to endure...the good news
is I already have tinnitus,tiredness,neuraphthy....Now I get to look forward
to a rash it looks like...sorry for sounding so neg..just sick of being sick!..My
suggestions for persons who have received one of these stints is to get a blood
count on your B Vitamins specifically the b-12 I do not think there is a way
to repair the nerve damage after you lack the B-12 another is to stop using Proton
Pump Inhibitors(protonix, prevacid, nexium, even zantac)-they cause me to have
severe explosive diarrhea, pepcid seems to be ok...or just good old mylanta or
tums! The pump Inhibitors does not allow your enzymes break down the Vitamin
in your food and the chemotherapeutic drug coating is killing the enzymes or
better known as intrinsic factor. So there is a double whammy accuring...another
safe bet would be to use the b-12 pills that you can place under your tongue.
That way you can get the B-12 straight to your blood bypassing your stomach and
feeding the nerves that are in danger of not getting the b-12 they need to function!
Also more good news I believe the medication in the stent only last for about
a year so after that hopefully the inflammation around that area will go away,
till then as I have learned in the past Grin! and Bear it! The alternative would
be nonexistance...and that would hurt everyone that loves you! Aaron Smith, Cumberland, Maryland, USA, November 18, 2007
Sharon -- we have sent you information about
the cardiologists who are conducting this study (also being done in
Texas). Allergic or sensitivity reactions are often difficult to diagnose
so we hope this
can be of some benefit. As for the stent being replaced, that can't
be done -- sounds like the stent began to restenose (tissue was growing
inside of it) and usually in these cases, either a balloon is used
to
open up the stent, or another stent is placed inside the original.
Keep us informed as to what, if anything, you find out -- and good luck. Forum Editor, Angioplasty.Org, November 18, 2007
I am very much interested in the stent
allergy study. I had a Taxus Express 2 Paclitaxel-Eluting Coronary
Stent March 2, 2006.
By
the end of May I was having trouble breathing again and retaining fluid.
By December 2006 I was having bad breathing problems so they went back
in the end of Dec 2006 and the right coronary artery which they had
placed the stent previously that year was grown over and blocked with
some kind of matter (doctors words) that they had to remove. The doctor
said if I continued to have a problem with it they would take the stent
out and replace it with another one. Since that happened I have had strange
things happen to me that the doctors haven't been able to explain. My
face, neck, arms and legs turn really red which is worse at times than
at other times but pretty much stays there. My throat and mouth broke
out with blisters and was really red. I don't break out with blisters
now but my throat, mouth and tongue all get really red and hurt. My throat
actually closed up on me and I had to go to the ER. It had been sore
for a couple of weeks and then I couldn't breathe one morning. Everything
in my mouth and throat was swollen. They did a CAT scan and said everything
was red and swollen all the way into my chest. NO Fever. My uvula, my
epiliglottis etc.... all red and swollen. That was Oct 11, 2007 and I
am still on steroids and my throat is still red, It is worse then better
etc.... I have nasal congestion too. I have been to a immunologist/allergist,
ear nose and throat, rheumatologist doctors and fixing to go to an infectious
disease specialist. Thus far everyone is clueless as to what is going
on. I also bruise really bad, have extreme fatigue at times and am hoarse.
Not sure where to go from here but was hoping that this could be the
answer.
Please respond if you think it is possible that the Taxus Stent may be the culprit.
I hope I have remembered everything. Sharon G., Texas, USA, November 18, 2007
Denise -- hopefully the group of Texas cardiologists
can help you. As for your developed sensitivity to Plavix, we just conducted
an interview with Dr. von Tiehl of the Scripps Clinic in San Diego. He
is the lead author of a study published in this week's Journal of the American
College
of
Cardiology, titled "Clopidogrel
Desensitization After Drug-Eluting Stent Placement". They've had great
success with this and he recommended that patients consult an allergist
who is
capable
of delivering drug desensitization therapy (probably one at a large university
center) and he/she can reference Dr. von Tiehl's article for
details. Forum Editor, Angioplasty.Org, November 18, 2007
Nov. 13, 2007: After 2 Taxus des stents, without
pre surgery consult as to choices in stent world, were implanted March
2006, I experienced a hypersensitive reaction to same. This created a
domino effect creating many more allergic reactions over the next 18 months.
I
even became allergic to PLAVIX after 9 months, so now what am I supposed
to do!!! I am not able to follow the lifelong duel antiplatelet therapy
that is supposed to protect me from clots? I have also developed allergic
reactions to SOY, MSG, NUTS, RAW FRUITS AND SOME RAW VEGETABLES, AS WELL
AS ANYTHING CURED, AGED OR FERMENTED AND MY RAGWEED ISSUES ARE OVER THE
TOP! Does anyone have any advise, I have enrolled in the study out of
Texas. Is my risk for clot increased because of my hypersensitive reaction???
The reaction I have experienced is softball sized hives, malaise,and
fever
for approx. 3 days. I have seen an allergist and take Fexofendine,4 Cimetidine
and Hydroxyz HCl daily. This prevents hives only until a new allergy
develops, and I must eliminate yet another food from my diet. Would anyone
like to
guess if this is temporary or permanent????? Denise Knoche, patient given no stent choices prior to surgery, Pittsburgh,
Pennsylvania,
USA, November 13, 2007
I think I have an allergy to the nickel in my stent. What can I do? William Lipoff, Plantation, Florida, USA, November 8, 2007
Every since I've had my Cypher stents I have been
living in pain and lost my ambition. I have pain in the muscles of my arms
and legs, pain in my joints,
and a very annoying pain in my back between my shoulder blades. I told my primary
care doctor and he took me off the statin drugs that he put me on. It's been
over 6 months and I have been living on motrin and getting more annoyed with
the doctor who looks at me like I am crazy when I go to see him with the same
story. Is there any help for me? Elizabeth W., Roseville, Michigan, USA, October 24, 2007
Update to May 6, 2007 posting for William Blanton
regarding cypher drug eluting stent. We finally heard from the University
of Texas-they don't think the inflammation found in Bill's mouth is related
to the stent but don't know what to make of it. This week Bill was to
his heart doctor and his doctor finally told him it is a reaction to the
stent.
They don't know what to do since you cannot stay on prednisone for any
length of time. He said at least you are not dying just suffering. I
am not sure what that exactly means. They won't risk taking the stent out
unless he gets in the position he is dying from it and it is the only
hope.
They might attempt it then. They said the stent is affecting his immune
system that is why he has skin problems, allergies, sore throat, severe
mouth and tongue pain. It is causing the inflammation in the mouth. They
cannot give a prognosis since they do not know that much about this.
His condition is chronic and he will have to live with it however long
that
is. The only real hope for the future is possibly a new drug that might
help relieve some of the symptoms. We are not there yet. We have given
up on any good out come with this. On the issue of fatty tumors- Bill
had one on his arm before he received the stent-he now has two. Someone
on
the forum asked about this-don't really know what this says either. Once
again thanks for listening and I hope all of you on this forum find a
answer and some help. My heart goes out to all of you and thanks to the
forum
for making this insight available to all of us. If anything changes or
we get anymore information I will let the forum know. Thanks again. Terrie Blanton, Hamilton, Ohio, USA, October 19, 2007
I am experiencing the same symptoms: Dull, chronic
chest pain, tiredness, etc. along with arm, shoulder, and back pain.
These symptoms are lessened with
exercise (I am in Cardiac rehab). These started almost immediately, and are
fairly constant. I talked with my doctor, and because the last a long time,
and don't
worsen with activity, they say it is not heart-related. The worst part is the
uncertainty of what is causing the pain. I wish someone would make doctors
aware of these issues! Ken R., Georgia, USA, October 17, 2007
All, I am a 40 year old male with 15 Cypher DES
stents and a special covered stent to address an aneurysm in my LAD.
My first operation last year placed 8 Cypher DES stents - 5 in my LAD and
3 in my RCA. The recent stents were placed in my RCA and LAD in some
of
the locations that had restenosis, and new stents in my Circumflex. I
had a severe rash last year when the first 8 stents were put in. My cardiologist,
Dr. Samuel DeMaio in Austin, TX is a research cardiologist and a patient
advocate (he is an MD, a lawyer, and a electrical engineer - quite a
career
- and is involved heavily in research cardiology). When I had the rash
response, which was also accompanied by severe itching to the point of
driving me mad, he placed my on Zyrtec. I took the medication for about
2 months and it worked very well. When I quit taking it, the rash and
itching did not reoccur. After the last set of operations this year, I
never experienced
the itching and/or rash so I never required the treatment with Zyrtec.
Zyrtec is a drug used to treat allergies. I worked very well for me.
By the way, I exercise almost every day - weight lifting and cardio. The
benefit
of weight lifting - if your doctor deems it safe for you - is that it
appears to improve heart rate recovery. Gerald Merits, Austin, Texas, USA, September 7, 2007
I HAVE READ EVERYBODYS BLOG AND I HAVE THE SAME
FEELING THE BURNING SENSATION, THE ITCHINESS,THE URINATING PROBLEM, AND
THEN THEY WANT TO TAKE ME OFF THE PLAVIX! I
GOT THE WHOLE BENEDRYL & PREDNISONE THING WHAT ELSE HELPS? ANYBODY HAVE ANY
ANSWERS?
I AM ONLY 32 YEARS OLD.. I FEEL LIKE IM GOING CRAZY. DAN, GEORGIA, USA, September 6, 2007
Jo brings up a good point about what happened
to her husband. When a Thrombosis(blood clot) is formed in the stent
can it and will it move around in the heart. It would only make sense for
this
to happen, however I would like to have clarification. Thanks again for
all you assistance. Bob Puckett, , Snellville, Ga. U.S. A., August 07, 2007
Jo D -- curious as to how long after getting the
Cypher stent did your husband stop taking Plavix. And who told him that
was okay to do? His cardiologist? We hear your frustration with the healthcare
situation -- but stents have also helped many people, and we would say
that in the past year, the pendulum has swung quite far in questioning
the use of drug-eluting stents
-- many feel too far. Reading over your story, it's not clear in what
way the stent your husband got caused any problem, since his thrombosis
occurred
in a different artery from the stent, according to your doctor. Did your
husband get other help, such as rehab or a program of lifestyle changes
(smoking cessation, diet, exercise, etc.)? Did you know that studies
have shown distance truckers have higher rates of coronary artery disease? Forum Editor, Angioplasty.Org, August 6, 2007
My husband has had 5 by passes in 2000, He
did not have a heart attack. The only medication he was on was aspirin
and lipitor. Then in 2005, he was having pain down his arm , he is
an OTR driver. He was away from home, he went to a hospital in another
state,
they ruled out a heart attack, but ran dye to find a small blocked
artery. They put in a Cypher stent, put on plavix for 9 months or longer.
His
doctor let him stop taking plavix, two month later he had a heart attack
from thrombosis, however, the doctor said it was because he stopped
taking plavix, but he said it was not caused from the stent, because
it was
a different vein. now he is on plavix, lipitor, and toprol, he had
never had high blood pressure before the drug eluting stent, yet the
cardiologist
says it his problems had nothing to do with the stent. I have to ask,
money talks and I feel these stents have caused problems for a lot
of people and the doctors benefit from the stents because the drug companies
spend millions on them to push their products. The FDA must also benefit
from the large money drug companies. Do they have any idea what kind
of trouble they are causing these people trying to keep jobs with insurance
and the companies don't want to employ these people, it is a serious
situation for many people and our government does not seem to care.
All
I can say is thank god there will be a time when everyone is equal
and money
can't buy anything! Jo D., Oklahoma, USA, August 2, 2007
Greg and T.C. -- we can understand your frustration
and worry. As we've stated numerous times, there are many different possibilities
for the type of reactions described in this Forum Topic. It is difficult
to discern what is a drug reaction and what might be something else.
As for the "something else", little
research has been done on this
phenomenon.
Hypersensitivity (or allergic reaction) to the coatings (a.k.a. polymers)
that are on the Cypher or Taxus drug-eluting stents has
been the subject of only one peer review article -- it was published
in December 2005 in the Journal of the
American
College of Cardiology (see our piece, "Drug-Eluting
Stents May Cause Allergic Reactions"). Already at that time,
we had numerous postings on our Forum from patients describing symptoms
like yours. A year ago, the group of cardiologists who wrote that article
came to Angioplasty.Org to see if we could refer patients to them --
they were quite sure that such a sensitivity existed, albeit an extremely
low incidence, and were trying to develop a test to confirm such a reaction
in patients. We have
been
referring patients on this Forum (see the right side-bar) to the study,
but the cardiologists have been hampered by lack of funding and no assistance
whatsoever from the two FDA-approved device manufacturers -- they actually
have to purchase the stents retail in order to obtain material for
allergy testing. These
were
matters that Angioplasty.Org communicated to the FDA -- most recently
during the
FDA's two-day DES safety hearing in December 2006. We
also feel that the hypersensitivity reaction may be
an indicator for increased risk of late stent thrombosis, but this is
only an unproven hypothesis. By all means, contact
us regarding the Stent Allergy Study, and feel free to write the
FDA and your representatives in Washington about this situation. On the
brighter side for patients is the fact that the next generation of drug-eluting
stents, in particular the Endeavor stent made by Medtronic and the Xience
made by Abbott, use different polymer coatings that are supposedly more
biocompatible. Forum Editor, Angioplasty.Org, July 21, 2007
In Dec. 2005, I had a Cypher stent placed in
my proximal LAD after an MI at age 38. I have had dull chronic chest
pain ever since. I have had two subsequent
angiograms, one even with IVUS, and everything looks great and the artery has
great flow. I have seen experts in three different university centers and none
of them has an answer. The dull chest pain drives me crazy at times on days when
it is particularly bad. I have always had a healthy diet, nonsmoking, athletic,
person with no family history or other risk factors. My last doctor was the most
thorough and he thinks it may be a local inflammation/allergic reaction to the
stent coating. Up to this point I had ruled out allergic reaction because, unlike
most accounts, I have had no other symptoms, of an allergic reaction (skin rashes
or hives). However, the doctor described cases in which pathologists have performed
autopsies on people who had once received drug-eluting stents and discovered
signs of local inflammation. I wish Johnson & Johnson, and other stent manufacturers,
could provide very small samples of the drug used on the stent for allergists
and other doctors to do skin tests to help identify the cause. Greg K., Nevada, USA, July 20, 2007
Last August my mother had a medicated stent
inserted. Since then her health has constantly declined. All along
she has said she felt better before the stent was inserted. She had a
rash
after surgery that was explained as being a reaction to the Lasix medicine
she was prescribed (even though she had taken it before without any
problems). She was also put on Plavix. She complained of pains in her
neck and throat
and excruciating pain in her back and leg. She slowly lost her appetite
and in December she was forcing every mouthful down. End of December
she was prescribed Edecrin for fluid since everyone thought she was
allergic to Lasix. From Jan 1 to April 30th she was in the hospital 3
times. The
last time was over 30 days with severe vomiting and diarrhea. Nothing
helped! Needless to say she was down to nothing but skin and bones.
Finally after inserting a feeding tube we were able to bring her home.
Every
test that has been run has come back negative. Everything looks great
and the doctors can t find anything that's causing her problem. Since
discontinuing the Ederin in May, the vomiting stopped but her health
still hasn't improved. Before the stent she was a dynamic 76 year old.
She was very active. Always on the go and doing things for others.
Now, she barely speaks unless you ask her something directly. She s able
to
slowly walk from one room to the other and that s all. I found this
website searching to see if anyone else had experienced the same problems
as
mom. Has anyone found anything that can be done to help people whose
system can't tolerate these stents? Mom is slowly slipping away from
us. T.C., Florida, USA, July 7, 2007
Chad -- if you read through these posts, you'll
see others worrying about nickel allergies writing in. Whether or
not this is your wife's problem is something that you should discuss with
an
allergy
specialist.
That being said, we refer you to our
posting from April 10, 2007. Stents
that contain surgical stainless steel all carry a warning to physicians
in their package insert that patients with a known sensitivity to stainless
steel or nickel may suffer an allergic reaction. And this applies
to all stents, not
just
drug-eluting
stents. There are some stents made with titanium, but they are usually a
titanium-nickel alloy. You've raised an important issue and a problem.
Patients who are potential stent candidates should be asked about allergies
-- certainly all patients need to take the initiative and make their physicians
aware of this condition because many surgical implantable devices are made
with nickel. Your allergist may be able to recommend some form of therapy.
Please let us know how you fare and thank you for writing in. Forum Editor, Angioplasty.Org, July 3, 2007
in short 12 heart caths in 10 years for 11
stents placed total. 1 triple bypass at the ten year mark. Is there
a possibility of a nickel allergy causing all of the heart caths? My
wife
has a severe nickel allergy. 7 months after the triple bypass she had
to have the wires removed from her chest because they contained nickel.
We recently learned the all of the 11 stents have at least 2%nickel
in each. She has been diagnosed with multiple illness that are possible
linked to an allergy to nickel. Her health is quickly getting worse
with
no answers as to why. My thought is the elevated levels of nickel being
released constantly from all 11 stents. Cardiologist says impossible,
By-pass surgeon says absolutely, primary physician says yes also. If
so, why were we not informed of nickel in the stents even though we
asked every time. Doc's always answered 100% titanium. How to reduce
the effects
of the nickel? Chad Lehan, concerned hubby, Spokane Washington, June 24, 2007
Thank You Terrie
Blanton [May 6, 2007] for your post. I have been in contact
w/ a Dr. at University of Texas. But as of yet haven't been accepted
for the study. My GP is checking on some things before I send the
paper back stating I want to participate in the study w/ my signatures
on them. This seems to be a long process to me. I found this site
in March of this year and sent a request that month.This is early
June and I really hope the process speeds up soon. I don't hope to
give other people a negative impression of the study. Apparently
I assume it does take time to get accepted and get the actual study
started. But to me every day that goes by seems like a long time
dealing w/ the joint pain and rashes and now off and on itching.
I estimate I have been dealing w/ the problems for 4 years now and
feel worn down or out from it all. Paul T., Illinois, USA, June 2, 2007
Since my stent placement DES I have been losing
weight and it will not stop. I have lost approx. 38 pounds in the last
5 months. Has anyone else encountered this problem?? If so, what was
the cause if you know? Norman Z., Michigan, USA, May 16, 2007
Hi everyone; greetings from Down Under. I had
a BMS put into my RCA eight years ago. I was only 46 and till then very
fit and healthy. I did not have a heart attack, but suddenly developed
angina and coronary artery cramps. During an angiogram my RCA was called
as being 99% blocked! For two years afterwards, I felt as though I had
someone inside my chest repeatedly jabbing me with a knife, or similar
sharp object. It was disconcerting, to say the least. I also developed
severe tinnitus. However, all the pains gradually subsided and became
very intermittent and I learned to live with it. The more active I was,
the better I felt. Unfortunately, the ringing in my ears persists to
this day. Some say the meds are the cause, others say no. I just live
with it and get on with things. Three months ago I had a sudden heart
attack and the BMS reblocked. I was so bad I was flown to Melbourne (the
capital city of Victoria) by helicopter. In the cath lab they called
my RCA as 99% occluded again. Now, that was a close call! They tell me
the damage to the heart is minimal, but I probably wont be able to climb
Mt. Everest. Ever since, I have been feeling a million dollars. For around
three weeks I would suddenly get very tired during the day; like running
into a brick wall. So, I would have a sleep, maybe for a half hour, maybe
for a couple of hours and then I would be fine again. Now, I feel great.
No pains, no aches and I can chase my kids all round the park and apart
from being so out of breath after a chase that I am leaning on a fence
gasping for air, I have no ill effects. In fact, the more active I am,
the better I feel. The sad part of this story is that just prior to my
heart attack, I stopped taking my medications - Plavix included. I was
doing some high stress work for the Federal Government, often in isolated
areas and just not able to get to a Doctor to get my prescriptions renewed
- and I paid the price. They now have me on aspirin as well as the Plavix
and I am aspirin intolerant. Aspirin gives me very, very severe indigestion.
Fortunately I may only have to take it as an adjunct to Plavix for a
year. I am now trying coated aspirin. Don't forget, that a stent is a
foreign object in the body. Some bodies react very badly to foreign objects.
Mine did and hence all the weird and wonderful pains after I was given
the BMS. The new stent is a Cypher DES and it is inside the old one.
It is designed to slow down the growth of cells and so, logically, the
body can't react to it the way mine did eight years ago. Consequently,
I am amazingly comfortable. Amazingly, I am still fit and active. My
kids are still very young ( the youngest is only six) so I have to be.
Again, the more active I am the better I feel. What is often not addressed,
is the psychological aspects of heart problems, particularly when invasive
surgery has taken place. You feel invaded and you know the problem is
very serious, because that's why the doctors intervened. In a nutshell,
it's all very scary. I try to just get on with it,stay positive, ignore
aches and pains if they surface and be as active as I possibly can. My
indigestion is nothing compared to the possibility of being in a cemetery.
Never again will I forget my pills and tablets for any reason. I take
my hat off to modern medicine, because with out it, I wouldn't be here. John Keily, Rosedale, Victoria, Australia, May 16, 2007
OK, it has been over 5 months since my one stent
DES was put in and I am still feeling very tired, weak, chest pain, etc.
I am curious as to, is this the way life is now going to be forever??
Are people that are having these symptoms, dying off?? What is going
on? Please let us know. Norman Z., Michigan, USA, May 15, 2007
Anna -- certainly if you don't feel well, you
should discuss this with your doctor, preferably the interventional cardiologist
who stented you. But your symptoms may not be related to the stent. Allergic
reactions to stents are uncommon, but obviously, as this Forum attests
to, some are experiencing them. More common are side-effects from drugs
you may not have been taking prior to the stenting. For example, ACE
inhibitors sometimes cause coughing. Statins can cause muscle and joint
pain. As for worrying, there's a new study out this week that worrying
can definitely affect heart health and that doctors should be more attentive
to helping with this. Often an adjustment of medications can make a major
difference. Let us know how you fare.
And Terrie from Ohio -- thank you so much for updating
us all on your experiences. We too hope the Texas study reveals some
information. This is a problem that obviously some patients are experiencing.
Even though it may be rare, it ain't rare if it's you! We second your
call to others to continue posting and updating this Forum -- it's just
about the only place where this issue is being discussed. Forum Editor, Angioplasty.Org, May 15, 2007
July 6th of this year I had 3 Cypher stents
put in the LAD. Ever since I have not felt well. Chest discomfort, coughing,
and constant worrying. I have also gotten some fatty tumors so they say
that's what they are on different parts of my body. I was reading the
book the other day that came with the card to carry, because of the stenting
and I read that the medication that is in the cypher stent Sirolimus
can cause tumor formation, also joint pain. I was wondering if anyone
has noticed that they have gotten any fatty tumors since they received
the stents and didn't realize that this may be what they are from. I'm
at my wits end. I was also wondering if I should mention this to my doctor.
I don't want to look like I'm nuts. But this does seem to make some sense
of why I have these tumors and are they really just fatty tumors. I would
appreciate any insight you may have. Thanks, Annie, Anna, Parkton, Maryland, USA, May 8, 2007
Back once again
with a update to my previous posting of November 4, 2006! Bill has went
through the testing with the University of Texas for possible stent allergies.
He had a slight reaction (redness of the skin), his doctor said it was
too slight to indicate a reaction. He then had to have a nuclear test
on his whole body to check for inflammation. This test showed inflammation
in the area of the mouth. The doctor's don't think this has anything
to do with the stent because inflammation wasn't found anywhere else
but have no idea what is causing it. The doctor said he is sure it is
not the stent but still can't rule it out. He also said he could not
remove Bill's stent because of where it is in the heart. The doctor also
said there are no more tests to run on him and the only suggestion he
could make is to go on a low dose of a prednisone and if it helps he
may have to stay on it the rest of his life. Bill is not considering
this at this time. Bill has had problems with his mouth, sore throat,
hoarse and all kinds of skin problems which started with the stent. The
last 3 weeks he has been able to use polygrip for the first time since
the stent. Everything else is the same-symptoms come and go.
The tests and films were sent to the University of
Texas a month ago and they are to let us know what they think of all
this. We found out from a friend of ours that has the same doctor as
my husband that our doctor told him Bill is a rare case. He is allergic
to something in the stent. He has had other cases but the symptoms usually
go away after 6 months but Bill's hasn't. After 20 months I have little
hope he will get better. Bill's doctor has never told him what he told
this other person but still says he is sure it is not the stent but can't
rule it out either. Bill has told his doctor all along he thought it
was the stent. Now, at this point in time, it has to be the stent or
some weird syndrome caused from plavix, etc, that he was on for awhile.
Bill and these other people on this forum are not from the twilight zone
with some alien disease. In my opinion, Bill's doctor has known this
forever and we have just been on a witch hunt. Bill and I are where the
doctors want us - giving up and just dealing with it day to day on our
own. They can't do anything about it so just go away and deal with it.
As for the medical profession there has been entirely too much miscommunication,
no communication and poor ethics. If we hear from Texas University we
will let the forum know. I think the study
in Texas once completed may give us some interesting data but that
is probably a year to 2 years in the making. I hope others follow through
with the study as it may be the only hope of any answers for us on the
forum. Thanks again for listening and would love to hear how some of
the forum group is doing that we have not heard from in a long while. Terrie Blanton, Hamilton, Ohio, USA, May 6, 2007
Linda -- when you say "blood clots",
we assume you mean blockages? It sounds like what happened was that your
husband went for a diagnostic angiogram -- a test to see if his arteries
had blockages. One question is why he saw the cardiologist in the first
place? Was he having symptoms? Chest pain? In any case, usually cardiologists
tell their patients who are having an diagnostic angiogram that if they
see a blockage that definitely needs opening up, they can do it right
there and then, adding only 20 or 30 minutes to the procedure, rather
than bringing them back on another day and going through the whole needle
puncture of the groin artery etc., all over again. Sounds like you and
your husband did not understand this -- sounds like better communications
were needed. (By the way, angioplasty/stenting is technically not "surgery".)
Anyway, here's our recommendation, because we (or any other internet
site) should not be giving out medical advice. Talk to your husband's
cardiologist. Let him/her know that you were disturbed when you found
out that an intervention was done and that you weren't prepared for that.
Maybe they'll say it was in the consent form -- and maybe it was -- but
the fact remains, you weren't prepared for it. But communications aside,
don't let the problems that your husband is experiencing go unreported.
Some of the symptoms you list may be drug-related (drugs often affect
the elderly more, and tiredness, shortness of breath, and especially
bleeding, if your husband is on Plavix and aspirin, are drug side-effects.
But DO NOT (that's capitalized for a reason) stop or change your medications
without discussing this with your husband's cardiologist. Stopping Plavix,
for example, can be very dangerous. It is unfortunate that he (and you)
feel distrust at this point. But it sounds like you have a reason. Poor
communication may not seem like a big deal, but sometimes has profound
effects. Maybe this can be resolved when you explain yourselves to your
cardiologist. We would hope so. And that as you go forward, adjustments
to medications, etc. can be made, and that you and your doctor can work
together to achieve a better result. Please let us know how things go.
And thanks for sharing your story. Forum Editor, Angioplasty.Org, May 5, 2007
My husband is 85 years old. He has high blood.
Last year November 27, 2006 the heart doctor stated that he needed to
go to the hospital as an outpatient to check and see if he had any blood
clots. We did exactly what the doctor stated us to do that day. The next
thing we knew he was having surgery in which we was not inform of by
the doctor. He stated that he just wanted to check to see if my husband
had any blood clots not surgery. Anyway we was betrayed by the doctor
and now my husband is having a lot of problems since that surgery. The
doctor stated that he had two blood clots but they could only unclot
one because of his age and health condition. Now today he suppose of
went back for the second blood clot on April 3, 2007 but my husband is
afraid to go back to the doctor. Now he's having more difficult problem
breathing; tingling in the hands and feet; coughing up blood; nose bleed
and running nose constantly; constantly belching and chest pain; feet
swells up; sleep all day; tired and depress; lack of memory forgetful;
lost of appetite etc. I do not know what else to do for him because he's
afraid of any doctor now and I cannot get him to go back for a checkup
on this follow up from surgery to find out what is going on with his
health. We don't know if he has the Drug-Eluting Stent or the Bare-Metal
Stent that could be causing Allergic Reaction or Side Effects. Linda Jones, Fresno, California, USA, May 4, 2007
Brian H. I just want you to know that I too
had tingling in the hands and feet and it finally went away. It took
about 3 or 4 months before it went away. I too still have some symptoms
of discomfort and am taking place in a
stent study in Texas. Please let us know how you are doing. Norman, Michigan, USA, April 30, 2007
Lisa from Traverse City, Michigan. I had a stent
put in after taking Plavix for 10 days. A month later I began having
terrible continuous belching, so loud people in the next room could hear
me. The doctors finally decided after 2 months that I had an infection
in my stomach. Bernie, Illinois, USA, April 18, 2007
Has anyone out there experienced unexplainable
burping after being put on plavix? My father-in-law had a stent put in
last fall and then put on Plavix. He has this burping that is a mystery
to the doctors in our area. Any ideas??? Lisa, Traverse City, Michigan, USA, April 17, 2007
i am a 55 yo male with 6 stents and double
bypass. 2 stents were put in after the bypass. the last 2 were taxus
stents. the stent clogged up 21 days after the insertion. i have constant
chest pain and my blood pressure goes up and down, with the high so far
was 232/126. i am constantly tired and depressed, so depressed i left
my wife because i felt like i was no good to her. the last stent was
put in the 1st septal [branch] which caused the mi and my doctor stated
he had gotten into a lot of trouble by the head of the cath lab for putting
the stent there, why do doctors do this? i am totally disabled due to
the pain and breathing prob. Ray G., Maryland, USA, April 13, 2007
Thanks for your quick response. I have just
talked to my doctor's nurse who tried to tell me that stainless steel
did not contain nickel, and that if I had concerns, the doctor would
not perform the procedure. (I think I was fired as a patient?) I am suppose
to contact her with my decision to proceed this afternoon. Jean R., Tennessee, USA, April 10, 2007
Jean -- Please be advised that we are not doctors
and thus do not offer "medical advice". Any information or opinion from
our web site should not be used as a substitute for medical advice from
a licensed MD. That being said, we can tell you that all medical devices
come with a DFU (Directions for Use) which is produced by the manufacturer
and required by the FDA. Pretty much every DFU for stents which are made
of stainless steel (which also contains nickel) warn that in some patients,
these devices may cause allergic reactions to the metal. For example,
the DFU for the TAXUS stent reads, under WARNINGS: "Patients
with known hypersensitivity to 316L stainless steel may suffer an allergic
reaction to this implant." The Cordis CYPHER stent (as
well as most bare metal stents) have similar warnings. A web page from
the FDA that addresses this problem can be found at: http://www.fda.gov/cdrh/medicaldevicesafety/tipsarticles/allergies.html Hope
we've been of help. Good luck. Forum Editor, Angioplasty.Org, April 10, 2007
I had a heart catheterization last Thursday
and they want to proceed with a stent later this week. After doing my
homework and realizing the stent is made of metal containing nickel,
I called my doctor's office and informed the nurse of my severe reaction
to nickel. She indicated that she had not heard of a problem and would
check. No one has called me back. Should I be concerned, should I cancel
the procedure. Help. Jean R., Tennessee, USA, April 10, 2007
I recently sent this letter to the Stent
Study group. Hope it helps someone. Correspondence welcome:
I first heard about your study regarding potential allergic reactions
to drug eluding stents through the Forum at: forums1@angioplasty.org.
I am very interested in participating in it. I have had two Cordis/Cypher
stents placed. One in December of 2004 and the second in January of
2005. I began experiencing strange body reactions within the first
two days and before I left the hospital with the first one. The early
symptoms were hot flashes with a body rash and intermittent itching,
usually followed by body chills. The assumption was that I was having
an allergic reaction to the contrast die from the angiograms. I had
had several of them before with no reactions at all. Once I arrived
at home I experienced daily nausea, extreme headaches, slight shortness
of breath, tingling in my face, tongue, throat, hands and toes, dizziness
and an intermittent bright red rash from head to toe. Not necessarily
all simultaneously. These side effects were strong enough to be debilitating.
As you might imagine the medical opinion was that new the Plavix therapy
I was on was the cause so I was then prescribed Ticlid instead. My
symptoms persisted so I was taken off both and remained on only a daily
325mg dose of enteric aspirin. There was no change in my symptoms.
I have repeatedly communicated these symptoms to my cardiologists and
primary physician who look at me like I have two heads when I mention
the possibility of an adverse reaction to the stents. Apparently these
reactions are rare. One cardiologist did change some of the blood pressure
(Toprol) and cholesterol medications (Lipitor) I was on with no change.
I have subsequently seen a neurologist, ENT specialist, allergist,
and dermatologist. Both the cardiologist and allergist have requested
samples of the stents so a skin patch test can be performed. The manufacturer
has failed to reply to these repeated requests or even contact one
of us. All of this is quite stressful and I am desperately seeking
some answers. Can you help me? Thank You.
Brian H., retired, Massachusetts,
USA, April 5, 2007
My husband had 6 DES stents implanted in April
2006. In September he started developing a rash, started itching, etc.
He has seen a dermatologist, has tried several meds, creams, etc. Nothing
works. Please forward us any information you may have regarding the study,
etc.
Thanks. Joyce P., Indiana, USA, April 2, 2007
My father in law has been seeing his cardiologist
and working on a eliminating various drugs from his system, one at a
time, since this started. They did replace Plavix with another drug quite
some time ago, with no success. They have since then replaced other drugs
in his repertoire (he has about 12 total to control his heart condition,
diabetes, arthritis, blood pressure, etc.) That is why his case is so
complicated. From reading the forum and the fact that the rashing started
about 3 days after surgery, we are suspicious it is a stent allergy.
Especially since he has not responded to the drug elimination. In addition
to this, no steriods or other anti-itch medications have been able to
help him. He also had a great deal of swelling in his legs and constant
water leakage. The water leakage has been controlled at this time by
the use of ace bandages. Your study seems like something we would be
very interested in. Especially since it is only a skin test that his
doctor can do. He actually has an appointment tomorrow. We will bring
this email in to show him. I will also contact the stent
allergy study. P.A., Maryland, USA, March 24, 2007
Elaina and Bob -- your suspicion is a good one,
although it is very hard to say for sure, which is why the group of cardiologists
who first described the hypersensitivity reaction to drug-eluting stents
in the Journal of
the American College of Cardiology are now engaged in a study to
find out more. The reactions you describe are similar to what has been
posted on this topic here and what the cardiologists have seen. We encourage
you to email
us for more information on the study. They may be able to identify
the source and help. Forum Editor, Angioplasty.Org, March 14, 2007
I too am one of the people who suffer severe
joint pain. I do have arthritis, but since the taxus DES's were implanted
I am getting to the point that Its really tough sometimes to even walk.
Getting off the sofa sometimes can be a chore because of the pressure
I have to put on my knees. My son even bought me a cane to help me walk.
I also take plavix and aspirin everyday, I have for 22 months but am
scared to come off because I have already had stent thrombosis once,
and believe me, I don't want it again. I'm glad to be alive, but didn't
know I was going to have to suffer this much. My hand even aches as I
type this. Bob P., Snellville, Georgia, USA, March 12, 2007
My husband is 54 and had a stent put in 18 months
ago, and at a year he broke out with the worst hives and rashes and welts
all over his body even the palms of his hands broke out and itched. He
also gets congested in his lungs and a low grade fever. We have been
to our family doctor and dermatologist. For the past two months, all
they give him is shots of steroids and oral ones to take at home. If
he tries to go off of them it starts all over again. This is not and
environmental allergy it is coming from inside his body and the only
thing in him is this stent. Now they want to test him for allergies but
this is not a typical allergy it is so severe. Has anyone else had this
after having a stent for over a year? We have been to five different
doctors and they can't figure it out. I really feel it has something
to do with the stent. Is this possible? Elaina , North Carolina, USA, March 11, 2007
George -- thanks for writing in your positive
non-allergic experience. It's a good reminder that having the kinds of
reactions one reads about on this Forum topic is not what everyone experiences.
In fact the vast majority of patients don't experience these problems.
That being said, the reason this Forum exists is to give a voice to that
minority. Forum Editor, Angioplasty.Org, March 11, 2007
Adding my experience. A DES was inserted into
my Left Anterior Descending Artery on 2 March due to 95% blockage. For
the record I felt better within 12 hours of the procedure. I returned
to a strong powerful feeling in my chest. My stamina is way up to last
year's levels so I have to watch my exhuberance to drive up to my past
peak. I am one of those anomalies. Health conscious, don't eat fast food,
maybe ate pizza 4x per year, usually eat oatmeal yogurt, that sort of
diet. Until I broke my ankle last year I was cycling 3x week @ 20-30
miles each and did strength training. I am describing myself because
I had no heart damage whatsoever. The cardio guy said my heart muscle
had extra circulation from my aerobics. So the stent essentially opened
up the flow. So far no sensation in my chest or the Aspirin/Plavix/Tomoprol/Vytorin
regime. I have further changed my diet to that of a cow. George, Clermont, Florida, USA, March 10, 2007
Dear Forum, Thanks for sending information about
the "Stent Allergy Study". It's good to know someone (a cardiologist)
is studying this possible allergy. Yes, my stent was a drug eluting stent.
I may have only had 1. They had talked about 2 but it may only be 1.
The drs. seem to find an explanation for these problems but I know I
haven't been the same since the stent placement. I had hoped to be a
model heart patient if there is such a thing ha. By doing all i was told
would be good for my health and heart, but it hasn't worked out that
way, unfortunately. I will talk to my Dr. again about possible allergy
when i see her and also let her know about the study. Then I may email
the cardiologist who is doing the study. BY the way, what is the side
of the drs and cardiologists on the subject of stent allergies? It might
be good to see both sides patients and Drs. Thanks, Paul T., Illinois, USA, March 6, 2007
Thank you so much for returning my email with
information about a possible allergy to the drug stents themselves. My
mother had two drug eluting stents put in in October 2006 and immediately
started having allergic reactions,including hives, rashes, itching, joint
and nerve pain. Her cardiologists took the normal course of action to
see if this reaction was to her Plavix. Six months later, my mom has
been on Plavix, Clopidogrel, Ticlid, Altace, and a variety of others
and her allergic reactions have not ceased. She is being treated for
these reactions, but the cardiologists have come to the conclusion that
she is allergic to the stents themselves. My mother does have a history
of severe allergies to medications. Mom's condition is getting worse
and she was told she could be looking at having more stents put in. She
is refusing this because of the "nightmare" she calls it of the last
6 months of allergic reactions. Any information you can provide is extremely
helpful and please put my comments on your forum, including this one
today. Your forum has already encouraged mom because she now knows she
is not going through this alone. Thank you for all your help. Kathy A., Oklahoma, USA, March 5, 2007
had mi in nov 05, had 2 stents placed in LAD,
not sure if bare metal or des.For last 12 months have had continual lower
chest and back discomfort,i.e. soreness, feels like a rash, but not showing
on skin. Had 2 stress tests, both negative, cardiologist has no idea
what it is. If I lay down symptoms go away, but I still have them sitting
down, any thoughts anyone? Ken, London, UK, March 4, 2007
My companion had two stents implanted in Nov.,
2007. He experiences lethargy, "funny feeling" in chest, heartburn, hiccups.
His blockage was 70% and he felt well before the stents. Now he sleeps
and is unable resume normal life-style. He takes Plavix and regular strength
aspirin. Symptoms were so bad one week after surgery that angioplasty
was done to check stents, with no problem found. Any help appreciated. B.C., Kentucky, USA, March 3, 2007
Steve Florida - Thanks for your response, glad
to tell you my history - in december 2005 I went to my doctor (GP) with
the following symptoms tightness in the chest, weird pain across the
shoulders, and pain / weird feeling of numbness/pins & needles in left
arm & severe discomfort in the throat/neck, all this when I walked & occasionally
when at rest. He diagnosed possible Angina & put me on Bisoprolol 2.5
mg and sent referral to cardiac dept in local hospital, for some reason
as yet not known I did not get to see a cardiologist until October 2006
when I had an exercise test (which showed a problem) from then on things
moved a lot quicker, at the end of November I had an angiogram - this
showed the right hand coronary artery was almost blocked (90%+) but this
side of my heart was being partially fed by what they called backwash
from the left side, it seems I had developed small blood vessels to feed
the right side (this is not unusual so I'm told) It seems my doctor (GP)
putting me on the beta blocker (bisoprolol) stopped a possible heart
attack. I was admitted to hospital on 31st January 07, went for balloon
angioplasty & stent on 1st Feb - I went on the table @ 9am all ok until
contrast dye was injected when I had allergic reaction to this iodine
based product - this was sorted OK - artery was totally blocked, cardiologist
opened this with the balloon and placed 2 DES - went back to the ward
and felt better straight away - no more pain since, I take plavix, simvastatin
- aspirin, (stopped Bisoprolol 2 weeks ago) I should point out that during
the time I waited for angiogram I could only walk about 50 - 100 yds
without pain/indigestion - nitroglycerine spray only gave severe headaches. David W., England UK, March 2, 2007
David
W from England: Thank you very much for posting a response. You
are indeed the first person I personally ever heard of who actually
felt better after a DES stent was implanted. And I have communicated
with dozens and read hundreds of posts all over the internet. Your
post did make an impression on me. If anyone else has had a true benefit
in chest discomfort from a DES stent, please also post. I and all of
us would of course like to hear from you too. It at least gives us
hope, and an interest to make sure there are no other causes of any
chest pain or other problems. My problem of constant chest pain started
immediately after the DES stent was implanted. David, your stent is
apparently very new. Did you actually ever have a heart attack? Or
just a stent on a doctor's recommendation. What exactly were your symptoms/problems
before the stent was implanted, i.e., med history? It has been posited
that if one had an MI, then the results of DES stenting are far less
beneficial, and chest pain may actually increase substantially. How
much better are you? Your post was very brief. Very curious. Thanx. Steve, Florida , March 1, 2007
Eli -- the original purpose of angioplasty was
to relieve angina. If you are experiencing angina more after stenting
than you were before, then something is not working right. Have you had
a followup angiogram or other test to determine if the stent is functioning
correctly? Also check out our related topic called, "Not
Feeling Well After Stenting". Forum Editor, Angioplasty.Org, March 2, 2007
hi i am 44 yrs old and live in uk . i had a
heart attack in nov 06 and a cypher stent placed on 2nd feb 07. My problem
is i am in so much pain with angina now than what i was before stent
was fitted. before i had the stent i could cope with the pain but now
it seems to be there most of the time and radiates down both my arms
it makes me cry, the pain is waking me up at night too. i was admitted
to hospital put on infusion of nitro which helped but was discharged
with pain killers next day i couldn't believe it. i have since paid private
to see a cardiologist and have been given isosorbide mononitrate this
doesn't stop my pain completely but takes the nasty edge off it and makes
it easier for me to tolerate. i wish i never had the stent. my life has
changed so much i cant do what i did before i hate it . could this be
an allergy to the stent or unstable angina. thanks Eli, Sheffield, England, February 28, 2007
Dawn -- check out the right-column side bar.
There is a group of cardiologists in Texas who are conducting research
on hypersensitivity to drug-eluting stents. They are developing a protocol
for testing this and are looking for patients who may be experiencing
these kinds of unknown symptoms post-DES. Click on the email link and
we'll send you contact information. Forum Editor, Angioplasty.Org, February 27, 2007
Hi everyone, I have posted here before.
Still having issues related to skin, others have mentioned rashes. In
my prior posting I noted that I have what appears to be a rash but the
dermatologists are calling it Granuloma Annulare. Has anyone else with
rash or rash appearing marks gone to dermatologist? and gotten same diagnosis.
They still say they don't know for sure what causes it and I really do
feel it is related to the stents I have. I have known metal allergies
to anything other than gold and sterling silver. I went to Mayo and their
diagnosis was the same, when I questioned the metal stents or the medicated
stents as factors, they quickly said "No" but for not knowing what causes
this they sure did not ask questions to try to find connections between
those that have this Granuloma Annulare. A gal I know, her husband had
medicated stents after I did and she said he has developed a rash that
looks like mine but on his chest. Does anyone out there have the same? Dawn Reich, St. Paul, Minneapolis, USA, February 26, 2007
I wonder if anybody found any over the counter
help for the rashes. I have two stents and three rashes -- one on each
ankle and one in the middle of my chest which only recently seems to
have cleared up. Both of the remaining rashes are small, round and refuse
to go away. Web searches have told me nothing (and no, these are not
ringworm or Lyme disease related). I also have the in the ear, behind
the ear, around the eyes and around the nose dry/flaky skin so any info
for that would also be helpful... Robert, February 21, 2007
To Steve
in Florida, Feb 12 -- I think you may be getting a distorted view
of the viability of the DES, Forums usually only seem to attract people
who have had problems and are looking for a way to resolve them which
is perfectly understandable, most people go to a forum looking for
answers that they are not getting from their doctors. I had 2 DES fitted
2.2.07. and it is like a magic wand has been waved, no more angina
pain, I can walk for miles with no discomfort (as opposed to 50 yards),
I do need to regain some fitness as I have been almost inactive for
over a year but that is coming back slowly, I have very mild 'cold
/ flu' symptoms that may be side effects from one of the drugs but
I can live with that,other than this all is good so far. David W., England UK, February 21, 2007
Cheryl -- it's not correct that the "drug
dissolves in two weeks". The Cypher has a "nominal elution period" of
90 days, although most of the drug is eluted in the first 30. The Taxus
also elutes a controlled dose in the first 30, although, depending on
the version used (slow or moderate release) 70-90% of the paclitaxel
drug stays in the polymer (is never eluted). But the polymer (plastic)
coating stays on the stent. With the current Taxus or Cypher, it does
not degrade and the cardiologists who are studying allergic reactions
to DES are pretty sure that it is the polymer coating that is causing
the allergic reactions. The protocol they have developed for their study
is pretty straight-forward and can be administered by a family physician
-- it involves stopping meds one by one, but only under their protocol
for safety reasons. Then a special skin test is done and the eosinophils
are measured (a type of white blood cell). A nickel allergy will not
increase the eosinophils.
And Steve from Florida -- you've posted a number of
times and we hear you -- especially that you've had nothing but trouble.
There are problems with these devices in some situations, which are being
identified. But your blanket statements about stents being harmful to
everyone and that no one has ever been helped by them is just not correct.
Six million people worldwide have been stented -- the big picture results
don't show a catastrophe in the making. A close friend of ours would
not be alive today if stents and angioplasty did not exist. However,
there is no question that DES have been over-used in this country. That
is now changing -- and newer hopefully better second generation devices
are coming. Surgery has its downsides as well, for example, impairment
of cognitive function is a well-documented side-effect of bypass surgery. Forum Editor, Angioplasty.Org, February 20, 2007
Well I
am back posting because even the Mayo Clinic has no idea how to
help my friend. Cardiologist is sorry this has happened to her, but
there seem to be no answers for her. The testing has been extensive
and even the cardiologist agrees since nothing else is wrong with her
then it probably is an allergy to the nickel, you will note I said
PROBABLY..even after all tests came back negative no one is willing
to admit that this is an allergy. Where do we go from here??? The one
suggestion was for a pain study group, but she has been to a pain specialist
group before and their only suggestion was for morphine which is something
she is not willing to do. The "storms" appear to be happening less
frequently, but I have also suggested she use COQ10 and magnesium as
supplements to some of the other medications she is on, since so many
of the medications she is on cause muscle and joint pain. The swelling
of her joints does appear to be a little more bearable, the rash is
still an all over rash to include her throat (which children's benadryl
seems to ease), but how much benadryl can one person take? I feel so
strongly that this allergy is something that should be considered for
every single person that is even discussing stents with their doctors,
I have spoken to several people and just my random discussions seem
to prove to me that a significant number of people suffer from this
allergy. I have discussed the stent allergy study to her, but I am
not so sure that she is interested in being subjected to more testing,
she is pretty fed up with doctors right now. She also is not having
a reaction to the drug on the stent, she is having a reaction to the
nickel in the stent. She has been told that the medication on the stent
dissolves within two weeks of the procedure, so she knows, or feels
relatively sure the reaction is to the actual stent which cannot be
removed. Cheryl, Phoenix, Arizona, USA, February 17, 2007
Update
to the Forum -- My cardiologist is changing my meds to Ticlid,
although I have to wait for it to arrive at the pharmacy. After seeing
my PCP yesterday to check my rash, he recommended that I not discontinue
the Plavix until I had the Ticlid. He suggested that I may like Claritin
better as it would not cause the drowsiness of the Benadryl (I was
taking 50mg). I did take the Claritin, as well as quartering the Plavix
tablet and taking the quarters over a period of a couple hours. Currently,
the rash has almost disappeared, and the itching is well within tolerable
limits. The Ticlid has not arrived at the pharmacy yet, and I am now
considering continuing the Plavix a while longer to see if my body
will adapt (I am encouraged by the University of Iowa study). The Dr
informed me that the Ticlid comes with a requirement of CBC blood tests
every two weeks and they would leave me on it for 3 months. The plan
for the Plavix was for 12 months minimum. They also plan a nuclear
stress test in 3 months, to be followed by another catheterization
to check on the stent's progress. If it turns out that the rash returns
after changing to Ticlid, I will contact the stent allergy study. Thanks
for your response and your forum. George C., Florida, USA, February 13, 2007
I have talked to
dozens of DES stent recipients, and read hundreds of posts on all kinds
of heart related web forum sites, in addition to this PTCA site. There
are many heart related sites on the net. I have never talked to or read
a post from anyone at all who actually said that their stent made them
feel "better", or that they truly felt the stent overall improved their
condition. (Though their doctors may have told them so). All have told
that their DES stent(s) made them feel much worse. I have only read of
one single person (personally) who simply said their DES stent left them "about
the same", but not worse. I think those reading this will have had the
same witness of reports by those they have talked to about their stent
experience. It almost always bad. This is not the situation with bypass,
for example. I have talked to a number of people that felt their bypass
at least lessened their angina, for example. Though the reports post
bypass were not perfect, some people I have read or talked to actually
were glad they had a bypass, especially those who had the single vessel
robotic, minimally invasive technique. What does this tell us about the
DES stent, compared to bypass, or preventive medicine, EECP, or many
other methods that many report satisfaction from. The DES stent is obviously
a poorly conceived product, that does not "work" in people to improve
quality of life. It is something that doctors should stop putting in
people, as they were warned in September by the World College of Cardiology
meeting. In europe, doctors are turning away form the DES stents significantly
after this meeting. In the US the doctors are continuing to endanger
and harm thousands of people each week by putting these DES stents in
people. Steve, Florida, USA, February 12, 2007
George -- Our
quick recommendation in your case is to discuss the possibility of a
Plavix allergy with your interventional cardiologist, really the best
person to make any adjustments in your treatment. If he/she thinks you
may be having an allergic reaction to Plavix, it may be possible to switch
to an earlier (although related) drug called Ticlid (ticlopidine). We're
also sending you information on the "Stent Allergy Study". Forum Editor, Angioplasty.Org, February 12, 2007
I had a Cypher stent inserted in the proximal
area of the LAD six days ago (100% blockage, supplemented by collateral
growth of the RCA). Initially, I thought I was having an allergic reaction
to the adhesive on the electrode pads, since the rashes seemed to be
concentrated in those areas, Today, the rash has spread covering much
of the upper torso, front and back. I began taking clopidogrel 75mg immediately
after the catheterization (initial dose may have been higher, it was
more than a couple pills), been taking a daily 325mg aspirin for years
prior. The itching is fairly severe, and does not seem to respond to
benadryl, either orally or topical cream. Found angioplasty.org by Google
search looking for similar symptoms, and advice for relief. Not sure
what your study entails, but would be interested in participating. George C., Florida, USA, February 11, 2007
Brenda -- can you be more specific as to what
type of pain? Is it angina (chest pain?) Also where is it and when did
it start? Has he had any follow-up angiograms or stress tests to determine
if the stents are open? Forum Editor, Angioplasty.Org, February 10, 2007
Hi my husband had 4 medicated stents put in
1 yr 2 months ago.And is having so much pain from it i am so tired of
doctors telling us that they have never heard of anyone having any problems
with the stents and now i sit here and read and all i can do is cry for
him and all of you. because no one seems to care about any of us. I don't
no how long my husband can go on with the pain. he is 55 and was real
active, now he can hardly move and all i hear is they can't see why is
there no help for us!!!! Brenda W., Idaho, USA, February 9, 2007
Update
of posting from October 2006 where I was asking about a driver
stent. My husband was in great pain in his legs and hips, progressed
to almost unable to walk, using walking cane and considering a walker.
All tests re: arthritis which the Dr. insisted it was came back negative.
Suddenly the condition disappeared after 6 months of excruciating pain
in joints. The thinking now is that it is rare but that some people
may be caused by trauma after the stent is installed. Hope this is
of some comfort to others with this condition. Nora, Canada, February 7, 2007
Wow, Thought I was alone until I read many stories
about the pain we still suffer, have suffered and the ignorance of the
medical community as well as the fact that many docs simply aren't willing
to listen. Follow the money. I wasn't given stent cards, info or diagnosed
properly either. Still in pain looking for answers and almost every posting
rings similar. two heart attacks, last one caused by clotting and six
stents later few if any will own up to the fact that First Do No Harm
is second to First make a buck. Your stories and experiences are important
to me as you are the ones whom really understand what these stents are
doing to us. Keep fighting, Keep talking and Never Give up and Don't
be afraid to fire a few docs. As for me I won't take dying lying down.
Thanks again for this site It can/and has made a huge difference. I stumbled
on it in October of 06 after all my docs had no explanation and even
less information. Mike S., Florida, USA, February 6, 2007
Sheila --
Can't say if such an allergy "runs in the family", but the fact that your doctor
has been made aware and is treating the possibility is good. Our mission is helping
communications between doctors and patients, so each can do his/her job in improving
the patient's health. Forum Editor, Angioplasty.Org, February 6, 2007
I sure do appreciate all of your information.
Can I ask one more question? my father is allergic to the dye they use
for angiograms. do you think that is a family trait? (the dye allergy)
my Dr. does know about this and is planning some sort of pre-treatment,
steroids I think, but not sure. Thanks again, and I will be taking this
with me on "A" day for my dr. Sheila, Arizona, USA, February 5, 2007
Sheila -- Some stents are made of cobalt-chromium,
but they also have nickel. Has it been determined if you are allergic
to nickel?? The possible advantage of bare metal stents (as opposed to
drug-eluting) is that you don't need long term antiplatelet therapy (aspirin
plus Plavix) -- 4-6 weeks supposedly suffices. Bare metal stents also
have a higher restenosis rate -- especially in certain cases. But you
need to discuss these issues with your interventional cardiologist --
the one who will be doing your procedure. Good luck and let us know how
things proceed! Forum Editor, Angioplasty.Org, February 5, 2007
Hi! are there other stents available besides
the stainless and the drug-eluting? I have spoken with the medical facility
about these problems, they are also doing some research before they will
do the angiogram. ideally, I wont need a stent. (wishful thinking!) however,
it looks like I will with the comparison of my old tests to my new ones.
Thanks for your reply. Sheila, Arizona, USA, February 5, 2007
Sheila -- Make sure that the cardiologist who
is doing the angio knows these facts. An aspirin allergy and any metal
allergy is something that should be known before an angio (we assume
you mean angiogram, not angioplasty). If they decide to go ahead with
treatment for a blockage, be aware that stents are made of surgical stainless
steel, which contains nickel. They are contraindicated for patients with
a known allergy to stainless steel. An allergy to aspirin might impact
the decision as to whether or not to use a drug-eluting stent. Just make
sure you communicate these facts clearly to the cardiologist, nurse,
anyone that interacts with you. If possible, call them before you go
in. Forum Editor, Angioplasty.Org, February 5, 2007
I was wondering how a stent would affect me
if I have a metal allergy. I cannot wear jewelry that is less than 14k
gold, and I cannot wear any silver or the jewelry that is plated in gold.
also, I can only wear yellow gold, not the white or rose. I also have
an aspirin allergy. I am scheduled for an angio possible on Friday. Thanks Sheila, Arizona, USA, February 5, 2007
What are some of the possible side effects of
a drug eluted stent? My husband had one put in and I now worry what could
happen, especially when no one ever mentioned any concerns. Patricia S., Arkansas, USA, February 5, 2007
Peter -- very detailed post (and to all posters,
PLEASE try to keep them more concise -- if they're too long we try to
edit them, but we just don't have that kind of time these days -- we're
sure readers would prefer shorter posts). Anyway you've been on Plavix
for over three years and (this is NOT medical advice) you're probably
out of the woods vis-a-vis late stent thrombosis. But by all means do
what your cardiologist recommends. Your story is a good one that emphasizes
why drug-eluting stents were developed. You had bare metal stents that
restenosed (re-blocked). Your drug-eluting stents seem to have stayed
open (shingling and siding a house is not for the faint-hearted -- pun
intended). The rash you describe could be due to many different causes
-- since you were rash-free for three years post-stenting, it would be
difficult to assign this as an allergy to the stent or to a drug. Drug
allergies sometimes take time to manifest, but three years is a long
time. Were there any changes to your meds around the time of your rash,
and by meds we would include ANY over-the-counter meds or herbal supplements? Forum Editor, Angioplasty.Org, January 30, 2007
Hi, I'm glad I happened on to this program,
so I will add my experiences and questions. I am male, 72, been very
active, hard working most of my life, I quit smoking in 1983. The 16
years before retirement in 2000, my work consisted of Airport Fire Chief
and Maint. Supervisor. About 2001 I started experiencing shortness of
breath. I have not, and still don't experience chest pain. Oct. 2002
a stress test sent me to the Cardiologist where and Angiogram confirmed
my left Anterior Descending Mid Lab 99% plugged, which resulted in immediate
Angioplasty with, "I believe," 2 ordinary stents through the groin. Not
feeling any better by June 2003, tests identified continued problems,
and an Angiogram in Sept. 2003 proved the stents plugged. The 2 stents
were not long enough, so in Nov. 2003, 3 DEStents were inserted through
the wrist. What was a personal mystery is that my cholesterol blood test
results before my first angioplasty, was, total chol. 2.46, HDL 1.19,
LDL 0.87, Trigl. 1.06 and total chol./HDL ratio 2.1 , but the Cardiologist
related my problem to having smoked for some years. The discharge daily
prescription was, 325mg aspirin, 160/12.5 Diovan HCT, 50mg Metoprolol,
20mg Lipitor and 75mg Plavix, with Plavix to be permanent. Nineteen days
later, "on Dec.12, 2003," I experienced extreme pain like I was attacked
by a bunch of pit bulls, starting in my throat, "which proved real scary," then
went on to one ankle, to a wrist, and so on, usually in one or two places
at a time, each lasting about a day to a day and a half. The Doctor felt
it to be Lipitor side effects, so discontinued it, but the pain continued
till Dec.30 -- a total of 20 days. Tylenol hardly touched the pain to
where some nights I would try to walk it off.
From then on I can't say that I've experienced any
allergies or side effects till about 3 months ago, when I came down with
a progressing severe itch from the ankles, up the sides of the legs and
half way up my back. It is a deep torturing itch that does not want to
respond to scratching and keeps moving as I scratch. From the sounds
of some letters, could this be a side effect from Metroprolol? I tried
a prescribed cream without success, so after a home remedy hint, I lightly
sprayed apple cider vinegar on with a cleaned windex bottle and rubbed
it in, once a day for 3 days, each time the itch and pain subsided to
complete relief within 10 to 30 mins., and now my rash is almost healed,
with the itch and pain pretty well gone.
Lately I had one eye tested for cataract and the specialist
made an appointment for surgery, with instructions to discontinue aspirin
one week and Plavix 3 days before surgery, and to check with my Doctor,
who says he does not think it will do any harm. Not feeling comfortable
with all the scary information about stents and Plavix, I postponed surgery
till Feb. or March and am now waiting for advice from the Cardiologist.
I have now taken Plavix for more than three years, and I would very much
like to discontinue it. I have been informed that garlic has antiplatelet,
blood thinning, cholesterol fighting, blood/pressure and heart nutrients,
and I question if there is any truth to this, that I may possibly trade
Plavix for garlic? I am presently ambitious, reasonably active, taking
my time I shingled and side'd my house the last 2 years, and shovel all
my own snow without discomfort. [Editor's note -- this post has been
edited for length.] Peter B., Alberta, CANADA, January 29, 2007
Janelle -- we're sorry to hear of your husband's
problems. Sounds like he has a pretty complex medical history of vascular
disease. One quick thought is that if he has a history of atherosclerosis
in his coronaries AND his carotids, then it would be logical to assume
that the disease may also be in his peripheral vessels, such as the leg,
possibly the kidneys. Have these ever been checked? There are non-invasive
tests like CTA or MRA that can either eliminate these areas or flag them
for further diagnosis/treatment. Also you mention the Dr. -- is this
the cardiologist who did his most recent stenting? Interventional cardiologists
these days have moved into all the areas of the circulation and are doing
angioplasty procedures in the kidneys, legs, carotids, etc. Forum Editor, Angioplasty.Org, January 28, 2007
My husband (almost 59, at the time) had 2 NIR
stents placed in 09/2000. 2 days before he had a left carotid endarterectomy
6 mo. later, CABG and 2nd left carotid endarterectomy Has developed unusually
bad case of peripheral neuropathy. No diabetes or metal toxicity, supposedly.
All sorts of tests - no answer for neuropathy. 09/2006, had 1 Taxus Express2
stent placed. Was on lanoxin, inderal, 81mg aspirin, nexium, and then
clopidogrel. Experienced pain and unstable blood pressure, like prior
to last stent placement a few days later. ER decided it was due to spasms
during adjustment to stent. Husband has had extreme constipation - dr.
said not from clopidogrel. This went on for several months. Starting
having arrhythmias and legs were hurting worse; also sores in mouth and
on tongue and swelling of feet and legs. Dr. had him drop clopidogrel.
Didn't replace it. Bowels are starting to return to normal. The arrhythmias
persisted. Dropped lanoxin/inderal & added Toprol XL. Legs/joints/mouth
are not improving. Arrhythmias are worse, yet. In fact they are so bad,
he is now hoping for death. Blood pressure still unstable. Yesterday
range was 196/98 - 88/44, and pulse 59 - down to 33. Running out of answers,
and he feels he's running out of time. Don't know what to do. Janelle B., Arkansas, USA, January 27, 2007
Rodney -- we get so many posters who have a
problem after stenting, and then are diagnosed with "heartburn" and
given something to counter that. Each patient is an individual, so it
is impossible to make broad judgements. Current guidelines (just issued)
urge cardiologists to discuss the need for long term antiplatelet therapy
with their patients BEFORE stenting is done. Aspirin can definitely upset
your stomach, but do n't stop taking it (or Plavix) because antiplatelet
therapy is important to continue. If you think you may be esome allergy
to the stent, check out the right-hand sidebar. There is a study being
done on this subject. Forum Editor, Angioplasty.Org, January 26, 2007
DES stent sep 2006. Was not told about coated
vs uncoated and requirements for follow up meds. Asked doctor why I wasn't
told about risks and he went into defense mode and clammed up like a
stone. Put on Plavix, atenolol, aspirin, Vytorin. felt good 1st day muscle
pain caused me to stop vytorin. Currently heart burn, chest pains, burning
stomach. Had esophagus and stomach probe and scan. Nothing found. Diagnosis
was esophagial spasm. In addition to the above I was put on Protonix
and lorazipam. Protonix didn't help but Prilosec does. Helpers for relief
are eating, drinking milk, coke, water. I take the prilosec when I wake
up, wait a half hour then the atenolol and Plavix with a Slim Fast, pain
starts up about 11 o'clock and increases until I eat something. I take
the aspirin when I eat. Feel better for a couple of hours. In the evening
I feel pretty good. I eat a big snack before bed time, and now wake up
with no pain most of the time. If the pain gets real uncomfortable I
take a nitro pill. This helps a lot. But I'm scared of them. I've gained
6 pounds and I want to go the other way. I'm blaming my problems on the
aspirin and Plavix. This is scaring the **** out of me. Any help would
be appreciated Rodney Diehl, Gulf Shores, Alabama, USA, January 25, 2007
I just wanted to give a quick update. My husband
is participating in the stent
allergy study and we have booked an appointment with an allergist
for next week. His cardiologist agreed to it. He believes his allergic
reaction was due to the ace inhibitor and so he has avoided prescribing
that med or any med similar to it for fear that he will have a reaction.
Now he believes that it might help in his recovery if he were on that
type of drug so we are headed to the allergist. I'm hoping to receive
info from the stent study doctors by then so that I can share their test
protocol with the allergist. My husband's cardiologist also mentioned
that he could be allergic to the dye that is used in the angiogram. I
believe it is iodine-based. We're hoping to have him tested for that
too. We are definitely feeling a little better about his situation and
I thank the experts and people on this forum for that. We may not get
all the answers that we need but at least we're trying to get enough
information so that we'll be better prepared if there is another crisis.
We'll also have some valuable information for our sons, who may have
inherited their dad's illness and/or allergies. Maria S, Belchertown, Massachusetts, USA, January 23, 2007
Alan -- have you seen your interventional cardiologist?
You may be experiencing side-effects of some of the medications you're
on, but the cardiologist is the person to see. Also check out our topic
on "Not
Feeling Well After Stenting" -- anxiety, and some discomfort
iseems to be a common complaint, but definitely see your cardio -- and
let us know what you find out. Forum Editor, Angioplasty.Org, January 22, 2007
Greetings, I am interested in information regarding
the reactions to stents
study. I have one bare metal stent and one Taxus DES. These were
both installed on January 5th 2006 after I had a moderate/severe MI.
I continue to have symptoms such as those posted
on Jan 12 by John G from Florida. So far all of the tests have shown
good results and my MD is convinced my heart is functioning normally.
He is reluctant to say the DES could be causing my problems but has no
alternate explanation. Ken C., British Columbia, Canada, January 17, 2007
after having 3 drug eluting stents implanted
in my right coronary artery in november 2006 [ full metal jacket] i have
been back at emergency 7 times. Each time i go they do blood work and
an ECG but everything is normal, What causes me to seek medical care
is i get chest pain kind of like a nervous feeling in my chest with painful
arms and also sometimes shortness of breath and nausea and also very
painful neck muscles and shoulder muscles, all the symptoms of a heart
attack and also anxiety. Has anyone else had these pains? i am wondering
if it is maybe my meds i am on or the drugs eluting from the stents?
i am on 20mg lipitor,325mg asa, 75mg plavix, 25mg metoprolol twice a
day, 20mg pariet twice a day,50mg ratio sertaline and ramipril 2.5mg.
Any info would be appreciated as it is frustrating the hell out of me. Alan, British Columbia,Canada, January 16, 2007
• Today she told me her rash is easing and becoming
tolerable. Her doctor is sure it is the Ticlid. I will encourage her
to participate in the study. My family all wondered why a test had not
yet been developed to determine allergies prior to these procedures--especially
since the stents cannot be removed! Thanks for the feedback. Donna T., California, USA, January 15, 2007
Donna, as you have indicated, the allergic reaction
you describe might be related to Plavix (clopidogrel) which sometimes
doesn't show up immediately. But don't stop taking any medications, especially
Plavix, without getting a substitute, like Ticlid. And we encourage you
to look into the stent allergy study we are working on. Forum Editor, Angioplasty.Org, January 15, 2007
Hello, I am writing on behalf of my 78 year
old mother who has had nothing but trouble since receiving a total of
6 Cypher stents in a four-week period October 2006. She had a clot and
heart attack after the first stent. The doctor pooh-poohed my questions
about adverse reactions to medicated stents when I learned of what they
had done. And everyone ignored the rash we pointed out prior to her release
from the first procedure and the clot/heart attack. They actually upped
the Plavix after the second set of stents was placed. She is also allergic
to Ticlid. We heard second hand she is allergic to aspirin as well--need
to verify that. The severe rash makes her miserable and she is always
tired. Prior to all this she was an active healthy involved lady. We
feel helpless. Please send info on the study so I can ask her to consider
participating. I am going with her to her new cardiologists office today. Donna T., California, USA, January 15, 2007
TBS -- you are very specific in your test recommendartions.
Are you a health care professional? And we disagree regarding Alice not
telling her cardiologist. Patients should be open in communicating with
their physicians and confident enough to ask questions. Forum Editor, Angioplasty.Org, January 15, 2007
Alice -
I think your mom could have lupus. The symptoms you describe are classic.
The rash is called "butterfly rash." Sometimes it is drug induced. [If
you wish, please post the names of the meds, including any vitamins and
supplements -- editor]. Tell her to call her family doctor and get an
appt. Don't tell the cardiologist! No one test has adequate sensitivity
or specificity to detect all LA and both screening and confirmatory procedures
are necessary. Screening assays for LA should be sufficiently sensitive
and could include activated partial thromboplastin time (aPTT), dilute
aPTT, dilute Russel viper venom time (dRVVT), Kaolin clotting time (KCT),
Taipan snake venom clotting time or silica clotting time. In evaluation
of a patient for LA, at least two screening tests should be used. One
of the two screening tests should be based on a low phospholipid requirement
(such as dRVVT or KCT). If a single insensitive screening test is used,
80% of LA will be missed; whereas, if two appropriate screening tests
are used, more than 90% of LA will be identified.11 The sensitivity of
the aPPT depends on the reagents used, but even the new more sensitive
aPTT assays are not as sensitive as the dRVVT for the detection of LA.
A more sensitive assay should be used if the aPPT is normal and LA are
still suspected. TBS, Mississippi, USA, January 15, 2007
Natalie -- excellent point. An interesting phenomenon
is that of late stent mal-apposition. That is to say, in rare cases,
well after a stent is implanted, it winds up not fitting as well as it
did originally (i.e. it is "mal-apposed"). This definitely
is a risk factor for thrombosis. Why the "fit" of the stent
changes is not known, but inflammation is a good guess. Forum Editor, Angioplasty.Org, January 13, 2007
Has anyone considered the role of inflammation
to the drug eluting stent. Inflammation, especially with a tendency to
clot, is a recipe for some of these symptoms. Natalie, Virginia, USA, January 12, 2007
John -- check out the stent allergy study (right
side-bar) and email us for more information. Forum Editor, Angioplasty.Org, January 12, 2007
Since having 3 stents
inserted, one being a Cordis Cypher in Jan 04 and two additional stents
(Taxus Express 2) put in in Aug 04, four months later began some serious
problems with chest pain, swelling in chest on left side going up into
the neck and down the left arm. Tightness in chest restricting my breathing.
Test negative. 1st Attack 4 months (December 05) later same symptoms,
test and treatment with anti inflammatory, muscle relaxers, pain control.
2nd attack (April 06) again 4 months later.. taken off Statin therapy
at this time, Same test same Results, No heart problem, no infection,
and no explanation for the excessive swelling, pain and so forth. 3th
Attack, Aug 06, Same test same results, same treatment. Now again Jan
07, ER room visit, same test, same results. Now scheduled for follow
up with EKO Cardio test looking for fluid around the heart. could this
be allergic reactions to the Cordis Implant. Thank you for your assistance. John G., Florida, USA, January 12, 2007
The allergic reaction you describe might be
related to Plavix (clopidogrel) which sometimes doesn't show up immediately.
But don't stop taking any medications, especially Plavix, without getting
a substitute. These types of reactions are difficult to diagnose. Our
quick recommendation in your case is to discuss the possibility of a
Plavix allergy with your interventional cardiologist, really the best
person to make any adjustments in your treatment. If he/she thinks you
may be having an allergic reaction to Plavix, it may be possible to switch
to an earlier (although related) drug called Ticlid (ticlopidine). Forum Editor, Angioplasty.Org, January 12, 2007
Had medicated stent put in Nov. 22, 2006. Just
recently have started to develop skin redness and extensive itching over
various parts of my body. I have had periodic pain associated with chest
and upper right arm. Since stent procedure I have also had an increase
in dripping from the nose. Just had a nuclear stress test which indicated
that all seemed fine. What is this study all about? Do you think I am
reacting to the stent or the Plavix which I am taking along with 81mg
of aspirin. I was also taking Provastatin which the cardiologist changed
thinking this might have been the cause since most of the symptoms started
to show up more at night. I have stopped this, and the symptoms seem
to be getting worse. Any advice you can give me would be helpful. Thanks. Jack, Indiana, USA, January 12, 2007
JoAnn Again! In response to forum questions.The
heart palpitations started about 9 mos. after the second set of stents
were implanted. First it was the extreme flutters then the airway constriction.Like
many others I was never told about any dangers or meds. I would have
to be on long term.The Dr.said stay on plavix 1 year. I did that and
when I completed that year and stopped 4 mos. later I had a clogged artery
in one of the stents previously put in my heart.This makes me scared
to ever stop the Plavix. JoAnn, Mississippi, USA, January 9, 2007
JoAnn -- a few questions. You write that the
stents were put in in February and July of 2005, and that these heart
palpitations started after the stents. How long after? Immediately after?
Weeks? Months? And have you constantly had this problem since then (that's
a year-and-a-half to two years)? Has your cardiologist(s) offered any
explanation for these symptoms? Finally do you have any allergies to
metal or medications that you know of? Forum Editor, Angioplasty.Org, January 9, 2007
Hi! In Feb.05 I had 4 Cordis Cypher stents implanted.
In July 05 2 more Cordis. I stayed on plavix for 1 year. After the stents
I began having severe heart palpitations so bad it would close my airway.Went
to heart doctor. They put me on a holter monitor; it recorded irregular
heartbeats. I was put on varpimil. I was also taking tarka, lipitor,
diazide and 325mg. aspirin. The palpitations kept getting worse. I had
to go by ambulance to the hospital. I was being suffocated and had severe
chest pain there. They found one of the stents I already had was clogged
and had to have another put in; so I did. I was released the following
day got home and 3 hours later my heart was again palpitating so severe
it closed my airway and my husband is racing me back to the hospital.
The ER doctor gave me something for heartburn even though I told him
it was not heartburn. I told him it was my heart fluttering uncontrollably
and I couldn't breathe and it was like contractions it would go away
and come back! They gave me a nitro pill. I go home, two days later my
daughter is rushing me to the nearest facility which is a doctor's office
close to my home with the same problem. Dr. Moore put me on oxygen. She
took me in immediately -- you could hear me struggling for breath. I
know it scared her me coming in off the street like that and I've never
met her before, but it was an emergency.The palpitations are still coming
the airway closing isn't as bad in the last two weeks but the sharp pains
in my heart are still there. I was on the floor of my home tonight it
felt as though someone was stabbing me in the heart it lasted 5-7 min.
I couldn't get to my nitro pills.Then it slowly went away.Is this a side
effect? allergy? Please help -- I'm scared this is going to kill me.
Thank You For Your Help! JoAnn, Mississippi, USA, January 9, 2007
Alice -- check out the sidebar about the research
study being done. There currently IS no test to determine allergy to
drug-eluting stent. This study will do just that. But has it been determined
that this is not a Plavix allergy? It sound a bit like what we've seen
reported: skin rashes, etc. If it is the stent, it is more likely that
it is a reaction to the polymer (plastic) in which the drug is embedded
rather than to the drug itself (which is very low dose). Forum Editor, Angioplasty.Org, January 8, 2007
My mother had a cypher
stent inserted 9/2006 she has had a sore mouth four times since with
the pain being very bad. She also sometimes has a rash over her cheeks
and now gets small bumps on her face she says she has heartburn and upset
stomach quite often her cardiologist told her that she has an allergy
to the med on the stent no one told her of the risk she had the non drug
stent five years ago with no problems. She is also on plavix which she
didn't need with the other stent. Her cardiologist told her to call the
hospital so they can call the maker of the stent. what is this going
to accomplish. Alice Hall, Plant City, Florida, USA, January 8, 2007
Although I am very weak and tired I continue
to research the issue of nickel toxicity and the resulting hypersensitivity
to drugs and other life changing events. I am not going to give up until
I get answers that make sense. Therefore I have started posting articles
to a blog that I believe help explain what happened to me and others.
We must not give up the fight as others will be hurt by these products
if we do nothing. I am sorry for all of us. Here s the blog http://nickelallergytoxicology.blogspot.com.
My email address is on the website and if you have articles you would
like to post please send them to me and I'll be happy to publish them.
Again thank you all for being here and telling your story. My email is shha2002@yahoo.com Sharon H., Colorado, USA, January 6, 2007
Thanks to all who have written in -- and in
case anyone reading this thinks that patients aren't aware of what is
happening to them, just look at the last few VERY lengthy and detailed
accounts. We also call your attention to the study highlighted in the
right sidebar and urge anyone interested to email us for contact information.
(All emails are kept private and NOT shared.) Forum Editor, Angioplasty.Org, January 5, 2007
I am a 54 year old male who had a 2 stent procedure
on Nov 17 2006. One, a Taxus Express2 at LAD and one a Micro driver MX2.
Since these were done under an emergency situation there was absolutely
no discussion with me as to what my desire or even concerns were. After
the procedure I was told 2 stents were placed, I did not even know what
THAT meant. The following day a Social worker approached me and gave
me TONS of literature on the TAXUS Express, I was quite perturbed that
one of the listed side effects was DEATH . It also EMPHATICALLY said
that not more than one medicated stent should ever be placed in a patient
so, I am quite surprised reading here of people with 2 or more. My problems
began immediately after the angioplasty. My lips felt swollen and itchy
and so did my tongue. I had excruciating pains all over my spine which
the docs attributed to the length of time I spent laying on that damn
forsaken table. My neck and shoulder were also in horrible pain, but
NO pain killers were prescribed. Grin and bear it -- it could have been
worse. In the hospital I started taking Aspirin, Plavix, Lipitor, ave & TOPROL
XL.
All things considered, besides the extreme pain in
my back and the overall joint and muscle pain, I felt very optimistic.
I had a young and sympathetic cardiologist and the final prognosis was
that it has been a very minor incident so I could regain full functionality
of my life just with exercise and diet and of course STICKING to the
ever MIGHT PLAVIX. A night nurse told me if you do not have money to
buy the Plavix STEAL it because you will be back here in 5 months if
you stop it , it is a LIFE TIME commitment!. She also was VERY candid
and explicitly informed that this could have been discussed with me just
by popping a tab of nitroglycerin that would have let me take my own
decision and considered the risks. This MUST be taken upon by the FDA
to allow the patient if there is ANY possibility participate in what
will be come the rest of a very different life. If patient participation
was NOT diligently sought , the doctors should be considered FULLY responsible
for the treatment they decide to perform.
My throat began blocking and I was choking in the middle
of the night so I was taken off ALTCE because it is the only drug that
admits swelling in the lips tongue and throat , Diovan replaced that.
After 4 days of surgery I started noticing EXTREME sensitivity in my
gums (no bleeding) but they would hurt when chewing some a but tough.
One molar crown developed a terrible infection and turned the whole side
of the gum jet black. Running to the dentist they figured that my gums
have some how began being a lot more sensitive and than my immune system
around my teeth was not doing its job. After antibiotics, and pain killers
that went away but the area of the jaw has remained very dark and sensitive
and does not look healthy at all At this point the itchiness in my tongue
mouth and lips was getting to be a nightmare. and these were immediately
triggering panic attacks which required XANAX to bring me to the point
where I wouldn't t jump out of a window. The XANAX I had to get on the
internet because my PD REFUSED to prescribe it saying it would be just
another drug to deal with . Of course I am looking for a new primary
physician.
Since my doctors were REALLY not caring about this
I started experimenting and decide to drop LIPITOR two nights in a row
to see if I would achieve a a change. No luck , Then the Plavix one night
NO luck In fact dropping the Plavix made things worse . Since I can NOT
go directly to the stent and stop it from doing its jobs and I came to
something that was quite interesting, a reference to CANDIDA ALBICANS
. One of those nasty bacteria we all have in our bodies and when there
a change in the body s good flora they break havoc with your life. I
could have kicked my self because I had suffered from this after a especially
long antibiotic treatment about 12 years ago, but the symptoms were the
same. Crusty tongue cover with a slimy whitish coat. Blisters on the
side and under the mouth , roof of the mouse peeling and lips swollen
and itchy. Random aches and pains , brain fog bone aches etc. I more
severe cases you may have angula chelatis and even the infection may
travel to your esophagus. When does Cadiadisis kick in ESPECIALLY in
an environment like a hospital were you are being tested with this and
that drug , pumped with antibiotics and your oral hygiene may not be
the best ever. Your body is in a state of shock and are not combating
the Candida overgrowth a VOILA full blown case of Cadiadasis. So I am
looking at this itchiness (now spreading to my eyes) as a Candida overgrowth
(since all I get from the doctors is damn if I know ) For any of you
that DO have this mouth itchiness do this simple test, take the back
of a toothbrush and scrape off all the whitish glue on your tongue SPIT
IT OUT, now buy the MOST expensive PROBIOTIC you can get , cut a cap
in your mouse and let it sit there swooshing it around for 5 minutes
, now get a glass of water and swallow. Within seconds the itchiness
if not gone 100% it will not me making climb the walls. If a medicated
stent reaction is causing an overgrowth of Candida alvicans this can
be control pretty easily by adding and anti-fungal like nystatin, clotrimazole,
and miconazole to your drug cocktail. It took me 6 months to get rid
of my last Cadidaisis and trust me I was NOT expecting this devilish
fungus to make its presence again. But I think here it is and because
ALL of the CANDIDA symptoms mimic some of the side effects of the other
medications (like muscle pain and weakness in LIPITOR) I think MDs are
going about this all wrong. I would like to hear your opinions and courage
you to investigate CANDIDA and candidiasis on google, then match its
symptoms with YOUR systems after the angioplasty and be ready to be VERY
surprised. H. Forcelledo, Howard Beach, New York, USA, January 4, 2007
My husband (age 47) suffered a heart attack
in July of 2005. He was rushed to the cath lab and after an angiogram
they inserted a Cypher stent. They told us he had 2 more blockages, one
90% the other 30%. Two days later they were going to attempt to open
up the 90% blockage. Prior to doing that, they decided to check on the
first stent. We were told that it had “occluded.” The surgeon
inserted a second Cypher stent at that time. We were told the artery
initially opened up but then occluded again. He continued to insert 3
more Cypher stents in the same artery, “piggy-back.” The
artery was open and blood was flowing when they finished. They decided
not to attempt to open the other artery at that time. My husband was
put on Plavix, aspirin (325 mg), Lipitor, Lisonopril, and Toprol.
Prior to this event, my husband was hardly ever ill.
His cholesterol was 180 at the time of the heart attack, he was not overweight
and was very active (hockey and soccer player, avid hunter and fisherman).
He wasn’t on any meds prior to this event (not even bp meds). We
were told that he must have suffered from arteriosclerosis for a long
time, as he had an extensive network of collateral arteries that had
built up over time to compensate for the reduced blood flow. The plan
was to attempt to open up the other blocked artery after 6-8 weeks of
being on the meds. Two weeks after the heart attack and stent insertion,
my husband suffered an allergic reaction. He broke out with huge welts
(behind his ears, groin area). At first they told him to take Benadryl
but then his lips started swelling. At that point, we rushed him to the
ER and they immediately started him on prednisone. The doctors told us
that they felt he had an allergic reaction to the Lisonopril and so they
discontinued that med. Although the swelling in his lips went down, he
did progress to severe hives on his hands (which swelled and were very
itchy). His primary care physician needed to prescribe more prednisone
and he was even given an Epi pen, just in case the reaction suddenly
got worse. Eventually the allergic reaction subsided.
At the end of August, he went back into the hospital
to open up the other blocked artery. He was not taken off any of his
other meds. At that time they discovered that the stents had occluded
or blocked once again. Meanwhile, his 90% blockage had gotten worse (at
times it was full blocked) and the 30% was now 70-80% blocked (despite
the diet changes and all of the meds). They had to do an emergency quad
bypass the following day (Friday of Labor Day weekend). He is no longer
on any blood thinners (other than baby aspirin). He has to continue to
take Toprol XL (150 mg) and he must keep his LDL low (now under 50).
After reading about other possibly stent allergies,
I began to research the Cypher stent. The polymers that it is coated
with are acrylates. I’m a formulation chemist and I’ve worked
with these materials. I know that people can be very sensitive to them.
Although the doctors feel that he was allergic to the ace inhibitor,
that allergy was never confirmed. He was also never tested for allergies
to metals, the drug coating the stent or the polymer itself. Looking
at how the allergy took time to surface (2 weeks) and also took a while
to dissipate, I believe he was allergic to that stent (drug or polymer).
Was his system overloaded with the material (since he had 5 stents inserted)?
Did an allergic reaction contribute to the occlusion of the stents and/or
worsen his condition (contribute to the advancement of the arteriosclerosis)?
He is no longer on Plavix – does his CABG protect him from issues
that might surface because he’s no longer on the Plavix? He was
a very active person prior to his first heart attack. Although he tries
to remain active, he does not have the stamina that he had once before.
(Is it the illness or the meds that he is on?) We’d love to get
some answers to our questions and we want to be prepared if he should
become ill once again. He does not want to go through another bypass.
Until he is tested for an allergy to the Cypher stent, I would not want
to see doctors attempt to open up a graft using a DES. We’d also
like others to be more informed of the issues involving stents. They
may be fine for some individuals but for others, who have a history of
allergies, testing should be done before they are inserted. Patients
need to make informed decisions concerning their health care. We have
3 sons who may have inherited this same genetic weakness. We’d
like to be more informed for their sakes as well. For these reasons,
my husband would gladly participate in any research study involving possible
allergic reactions to stents. Thank you. Maria S., Massachusetts, USA, January 4, 2007
Response to S
in Mass. People think of the visit to the Dr. as some sort of courtroom
battle to be played out. Given your account, there is nothing to do
now but try things to make husband comfortable. Arguing with MD accomplishes
nothing, and nothing he can now do. Why increase the stress. Rather
go to the phoschol.com, click "library", click "phosphytidylcholine
as a Membrane Therapeutic, then click PDF and read the entire Chapter
4, so you are confident what it is; great studies and many of them.
Then find an MD (probably an alternative MD) in your area that does
Phosphytidylcholine IV therapy, and then e-mail me j@jgreenwald.com
and let me know if it helps. In fact if anyone does IV PC and has a
result, let me know. May help some. Nothing else I tried really helps.
The oral Phoschol product is nice too, but really didn't help me at
all; we stent folks need IV application and fast... Best to you... Steve G, Florida, USA, January 4, 2007
I'm a 48 year old male with four stents, two
drug-eluting in the last year, i had my first two non-drug-eluting stent
ten years ago. i did have some discomforting feelings in my chest but
they were not serious. BUT these two new stents, one that is inside the
old type stent hurts every day! i also feel weak, tired, have trouble
sleeping on my left side because of chest pains, unproductive cough,
joint pain,sharp pain in chest (heart area) while bending over. the list
goes on an on. can anyone give me some help with this?? R.M., Maine, USA, January 3, 2007
Steve G: With the latest
release of news concerning the adverse effect of DES on angiogenesis,
I am now convinced more than ever that it was the insertion of 5 cypher
stents that led to my husband's rapid deterioration, necessitating a
quad bypass within 2 months. He was told after his initial heart attack
that he had extensive collateral growth and that is probably what saved
his life. He did suffer some heart damage but they felt that there would
be no lasting effect. Again, his collateral system was considered amazing.
(Years of hockey, soccer, etc.) It's been over a year since his bypass
and his health has plateaued. (He is just 48 yrs old, not overweight,
never smoked and had not serious health issues prior to this.) Although
he is back to work and continues to try to stay active, he still tires
fairly easily. We are continually told it is most likely the Toprol.
I'm convinced it's the negative effect of the Cypher stent (allergic
reaction and/or negative impact on his collateral growth.) We go to his
cardiologist next week. What questions should we be asking at this appointment?
What tests can we ask for in order to determine if the stents (which
are still inserted) are continuing to cause damage? They told him his
hives/allergic reaction 2 weeks after the stents were inserted was do
to the ace inhibitor he was on. Would it be out of place to ask to have
him tested for allergies to that drug, the Sirolimus, and/or the polymer
coating on the Cypher stent? His appointment is on the 8th. S., Massachusetts, USA, January 3, 2007
I am 64 years old (female). On October 5, 2006
I had a Cypher Drug Eluting Stent placed in my right coronary artery.
I was doing fine until October 24th. I awoke that morning with severe
joint and radiating pain in my right hand which went to my wrist, elbow,
shoulder (felt like a torn rotator cuff) and my fingers became numb.
The next day the pain was bearable but by the afternoon of October 25th
the severe joint and radiating pain had moved to my left hand. On October
30 I was put on a Medrol pack because my hands were so swollen. The pain
continued in my hands, wrists, elbows, shoulders, knees, ankles and toes.
It would move from place to place. I ran an elevation of temperature
for two and a half weeks, had hives on the bottom of my feet and I itch
like crazy but do not have any red rash. By December 7th I was totally
exhausted and my Rheumatologist placed me on Prednisone until we can
find some answers. I have an elevated Sedimentation Rate but they have
been unable to come up with what is causing this. Because of the intensity
of the onset of joint pain both my Internist and my Rheumatologist asked
me had there been any new changes in my life or new medications The only
thing new was the Cypher Eluting Stent and Plavix. Do you think my joint
pain, elevation of temperature, hives and itching are a hypersensitive
reaction to the parylene C and the Sirolimus Drug? In December of 1995
I had a BMS placed in my right coronary artery and I had no problems.
I had a wonderful recovery. Suzanne G., Clarksville, Maryland, USA, January 1, 2007
The Cardiology
Patient Forum needs your help...
To Patients: If
you feel you might be having an allergic reaction to your drug-eluting
stent, you may be interested in enrolling in a research study
-- the only one of its kind -- to determine if you are having
such a reaction. For more information, email:
stentstudy@angioplasty.org
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